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Individual
RUBEN MERCADO
Active
Individual
RUBEN MERCADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1303295
—
MA
05
—
1307576
—
MA
01
—
M18463
BLUE CROSS BLUE SHIELD
MA
Enumeration date
10/01/2015
Last updated
10/01/2015
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