Provider Demographics
NPI:1568444719
Name:MERRIHEW, DONALD R JR (MD)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:R
Last Name:MERRIHEW
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:319 BAY RD
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-1402
Mailing Address - Country:US
Mailing Address - Phone:518-792-2181
Mailing Address - Fax:518-792-1531
Practice Address - Street 1:319 BAY RD
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-1402
Practice Address - Country:US
Practice Address - Phone:518-792-2181
Practice Address - Fax:518-792-1531
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2012-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY148341-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY50041CMedicare PIN
B80322Medicare UPIN