Provider Demographics
NPI:1831260348
Name:MERENS, DAVID W (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:MERENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:147 MILK ST
Mailing Address - Street 2:PROVIDER ENROLLMENT 9TH FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-4806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:228 BILLERICA RD
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-3604
Practice Address - Country:US
Practice Address - Phone:666-697-8250
Practice Address - Fax:978-250-6200
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD17766207V00000X
MA51371207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA17612OtherHARVARD PILGRIM
MAJ02295OtherBLUE CROSS
MA0765499OtherCIGNA
MA32330OtherFALLON
MA2086735Medicaid
MA0002837OtherNEIGHBORHOOD HEALTH PLAN
MA4196690OtherAETNA
MA051371OtherTUFTS
MA0765499OtherCIGNA
MA4196690OtherAETNA