Provider Demographics
NPI:1144567371
Name:MERNITZ, ROLAND BALDWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROLAND
Middle Name:BALDWIN
Last Name:MERNITZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11431 RAINBOW FALLS LN
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-4085
Mailing Address - Country:US
Mailing Address - Phone:317-577-9926
Mailing Address - Fax:317-577-9932
Practice Address - Street 1:11431 RAINBOW FALLS LN
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-4085
Practice Address - Country:US
Practice Address - Phone:317-577-9926
Practice Address - Fax:317-577-9932
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01020669208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery