Provider Demographics
NPI:1033110374
Name:MERRIMAN, DENA S (DPM)
Entity Type:Individual
Prefix:DR
First Name:DENA
Middle Name:S
Last Name:MERRIMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2846 PARNHAM DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-4700
Mailing Address - Country:US
Mailing Address - Phone:440-570-6396
Mailing Address - Fax:330-334-1535
Practice Address - Street 1:2846 PARNHAM DR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-4700
Practice Address - Country:US
Practice Address - Phone:440-570-6396
Practice Address - Fax:330-334-1535
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003368213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00144105OtherMEDICARE RAIL ROAD
OHME4134971Medicare PIN
OH4134971Medicare PIN
OHP00144105OtherMEDICARE RAIL ROAD