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Organization
MERCADO MEDICAL PRACTICE LLC
Active
Organization
MERCADO MEDICAL PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAX ENRIQUE MERCADO MD (OWNER)
(215) 289-4434
Entity
Organization
Contact information
Practice address
7500 CENTRAL AVE STE 203, PHILADELPHIA, PA 19111-2432
(215) 289-4434
(215) 289-7442
Mailing address
PO BOX 122, WYNCOTE, PA 19095-0122
(215) 289-4434
(215) 289-7442
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019063200001
—
PA
Enumeration date
09/28/2006
Last updated
06/30/2026
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