Provider Demographics
NPI:1144375825
Name:MERESS, STEVEN GREGORY (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:GREGORY
Last Name:MERESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 KNIGHTS WAY
Mailing Address - Street 2:
Mailing Address - City:FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54935-8080
Mailing Address - Country:US
Mailing Address - Phone:920-922-5433
Mailing Address - Fax:920-273-0480
Practice Address - Street 1:180 KNIGHTS WAY
Practice Address - Street 2:
Practice Address - City:FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54935-8080
Practice Address - Country:US
Practice Address - Phone:920-922-5433
Practice Address - Fax:920-273-0480
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI28559207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine