Provider Demographics
NPI:1982691580
Name:MERKHAN, SAMUEL K (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:K
Last Name:MERKHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:949 COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-2624
Mailing Address - Country:US
Mailing Address - Phone:518-828-7188
Mailing Address - Fax:518-828-5049
Practice Address - Street 1:159 JEFFERSON HTS
Practice Address - Street 2:SUITE D107
Practice Address - City:CATSKILL
Practice Address - State:NY
Practice Address - Zip Code:12414-1237
Practice Address - Country:US
Practice Address - Phone:518-943-1442
Practice Address - Fax:518-943-2003
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2007-11-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY209006207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01682842Medicaid
NY01682842Medicaid
NYF97356Medicare UPIN