Provider Demographics
NPI:1245434828
Name:MERRIMAN, DAVID JOSHUA (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOSHUA
Last Name:MERRIMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2580
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65801-2580
Mailing Address - Country:US
Mailing Address - Phone:417-829-4620
Mailing Address - Fax:417-829-4316
Practice Address - Street 1:1229 E SEMINOLE ST
Practice Address - Street 2:STE 230
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-2227
Practice Address - Country:US
Practice Address - Phone:417-820-5610
Practice Address - Fax:417-820-5589
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2010013500207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00985986OtherRR MCR
MO1245434828Medicaid
MO431560263OtherTRICARE
AR188157001Medicaid
AR188157001Medicaid