Individual
MITCHELL MERRIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
297 W UWCHLAN AVE, DOWNINGTOWN, PA 19335-3361
(610) 873-2100
(610) 873-2505
Mailing address
297 W UWCHLAN AVE, DOWNINGTOWN, PA 19335-3361
(610) 873-2100
(610) 873-2505
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC2575L
PA
111NS0005X
Sports Physician Chiropractor
DC2575L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0129330000
KEYSTONE
PA
01
—
086717
BLUE CROSS
PA
01
—
3656564
AETNA
PA
Enumeration date
06/29/2006
Last updated
11/18/2011
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