Individual
ANGELA MYRA MERCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1401 TIDEWATER DR, SUITE 1, NORFOLK, VA 23504-2840
(757) 623-0095
(757) 623-1203
Mailing address
1013 BRIARWOOD PT, VIRGINIA BEACH, VA 23452-4645
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101036323
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010198801
—
VA
01
—
176498
ANTHEM
VA
01
—
42036
OPTIMA
VA
Enumeration date
05/17/2006
Last updated
07/08/2007
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