MEDICARE: DR. DENA S MERRIMAN DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	36003368	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00144105	OTHER	OH	MEDICARE RAIL ROAD

General Provider Information

NPI Number	:	1033110374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENA S MERRIMAN DPM

Provider Business Mailing Address
First Line	:	2846 PARNHAM DR
Second Line	:
City	:	MEDINA
State	:	OH
Zip	:	44256-4700
Country	:	US
Telephone Number	:	440-570-6396
Fax Number	:	330-334-1535

Provider Business Practice Location Address
First Line	:	2846 PARNHAM DR
Second Line	:
City	:	MEDINA
State	:	OH
Zip	:	44256-4700
Country	:	US
Telephone Number	:	440-570-6396
Fax Number	:	330-334-1535

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	09/11/2008

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