Provider Demographics
NPI:1861457137
Name:MERKIN, RAYMOND PAUL (DPM)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:PAUL
Last Name:MERKIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11125 ROCKVILLE PIKE
Mailing Address - Street 2:SUITE G-1
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3142
Mailing Address - Country:US
Mailing Address - Phone:301-468-0441
Mailing Address - Fax:301-468-0805
Practice Address - Street 1:11125 ROCKVILLE PIKE
Practice Address - Street 2:SUITE G-1
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3142
Practice Address - Country:US
Practice Address - Phone:301-468-0441
Practice Address - Fax:301-468-0805
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD372213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD341940-02OtherMD BLUE SHIELD
DC7145OtherDC BLUE SHIELD
DC7145OtherDC BLUE SHIELD
MD0779540001Medicare NSC
MDT30926Medicare UPIN