Provider Demographics
NPI:1710785233
Name:MERIT SPINE LLC
Entity type:Organization
Organization Name:MERIT SPINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOEFFEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:612-219-4254
Mailing Address - Street 1:3715 FAIRWAY PT
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-5020
Mailing Address - Country:US
Mailing Address - Phone:651-208-5312
Mailing Address - Fax:
Practice Address - Street 1:3715 FAIRWAY PT
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-5020
Practice Address - Country:US
Practice Address - Phone:651-208-5312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-03
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty