Provider Demographics
NPI:1447507421
Name:MERRING, THOMAS R (PA)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:R
Last Name:MERRING
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 LIMESTONE RD
Mailing Address - Street 2:STE 101
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5408
Mailing Address - Country:US
Mailing Address - Phone:302-633-3555
Mailing Address - Fax:302-633-3350
Practice Address - Street 1:1941 LIMESTONE RD
Practice Address - Street 2:STE 101
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5408
Practice Address - Country:US
Practice Address - Phone:302-633-3555
Practice Address - Fax:302-633-3350
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEPENDINGMedicare PIN