Provider Demographics
NPI:1225284839
Name:MARCELO, MERWIN (RN, MSN, CRNA)
Entity Type:Individual
Prefix:MR
First Name:MERWIN
Middle Name:
Last Name:MARCELO
Suffix:
Gender:M
Credentials:RN, MSN, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7022 ROESPARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-8982
Mailing Address - Country:US
Mailing Address - Phone:740-548-6078
Mailing Address - Fax:
Practice Address - Street 1:7022 ROESPARK BLVD
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-8982
Practice Address - Country:US
Practice Address - Phone:740-548-6078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 254445367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered