Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 18889 | NJ |
NPI | 1255372421 |
---|---|
Provider Name | Robert W Mermer |
First Address | Voorhees, NJ 08043-3506 |
Second Address | Voorhees, NJ 08043-3506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 08/07/2007 |