Provider Demographics
NPI:1689879603
Name:MERRYFIELD, DONALD RUSSELL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:RUSSELL
Last Name:MERRYFIELD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10545 TODDS CORNER RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-5437
Mailing Address - Country:US
Mailing Address - Phone:410-763-8432
Mailing Address - Fax:410-763-8432
Practice Address - Street 1:1160 VARNUM ST NE
Practice Address - Street 2:#006 DE PAUL BLDG PROVIDENCE HOSPITAL
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017
Practice Address - Country:US
Practice Address - Phone:202-269-7103
Practice Address - Fax:202-269-7100
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCDEN22741223X0400X
MD44231223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics