Provider Demographics
NPI:1376039404
Name:MERRIWETHER, TAMERA MARIE (RDH)
Entity Type:Individual
Prefix:MRS
First Name:TAMERA
Middle Name:MARIE
Last Name:MERRIWETHER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4615 LOWELL DR APT 1803
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418-3127
Mailing Address - Country:US
Mailing Address - Phone:843-513-7992
Mailing Address - Fax:
Practice Address - Street 1:DENTAL CLINI- GRAFENWOEHR
Practice Address - Street 2:BUILDING 475
Practice Address - City:GRAFENWOEHR
Practice Address - State:BAVARIA
Practice Address - Zip Code:92655
Practice Address - Country:DE
Practice Address - Phone:964-183-1720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-01
Last Update Date:2018-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11139124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist