Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 021019 | OH |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 021019 | OH |
NPI | 1174053623 |
---|---|
Provider Name | Mr. William Merimee |
First Address | Cleveland, OH 44111-5612 |
Second Address | Cleveland, OH 44111-5612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2017 |
Last Update Date | 28/06/2018 |