Individual
WALTER WOODHULL MERRIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5792 WIDEWATERS PKWY STE 101, SYRACUSE, NY 13214-1847
(315) 422-4412
(315) 422-4432
Mailing address
5792 WIDEWATERS PKWY STE 101, SYRACUSE, NY 13214-1847
(315) 422-4412
(315) 422-4432
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
114080
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00550032
—
NY
Enumeration date
08/24/2006
Last updated
04/27/2019
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