Provider Demographics
NPI:1528291887
Name:DIOP, MERRILY (LIC AC)
Entity type:Individual
Prefix:DR
First Name:MERRILY
Middle Name:
Last Name:DIOP
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7219 FLOWER AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6433
Mailing Address - Country:US
Mailing Address - Phone:301-803-8170
Mailing Address - Fax:140-764-8352
Practice Address - Street 1:7219 FLOWER AVE APT 5
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6433
Practice Address - Country:US
Practice Address - Phone:301-803-8170
Practice Address - Fax:240-764-8352
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01524171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU01524OtherMARYLAND LICENSING NUMBER