Provider Demographics
NPI:1245839299
Name:MEHRER, TODD ANDREW
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:ANDREW
Last Name:MEHRER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 DOCS PLACE EXT
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19967-6751
Mailing Address - Country:US
Mailing Address - Phone:267-319-2767
Mailing Address - Fax:
Practice Address - Street 1:45 DOCS PLACE EXT
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:DE
Practice Address - Zip Code:19967-6751
Practice Address - Country:US
Practice Address - Phone:267-319-2767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF03674237700000X
237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE2022701050OtherBUSINESS LICENSE