Provider Demographics
NPI:1427078880
Name:JOHN R MERANDA & LINDA ELAINE WEBER
Entity type:Organization
Organization Name:JOHN R MERANDA & LINDA ELAINE WEBER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:MERANDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-599-8844
Mailing Address - Street 1:167 W MAIN RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:CONNEAUT
Mailing Address - State:OH
Mailing Address - Zip Code:44030-2057
Mailing Address - Country:US
Mailing Address - Phone:440-599-8844
Mailing Address - Fax:440-593-6014
Practice Address - Street 1:167 W MAIN RD
Practice Address - Street 2:SUITE G
Practice Address - City:CONNEAUT
Practice Address - State:OH
Practice Address - Zip Code:44030-2057
Practice Address - Country:US
Practice Address - Phone:440-599-8844
Practice Address - Fax:440-593-6014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty