Organization
DR. MAX E. MERCADO 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
1331 E WYOMING AVE, SUITE 3090, PHILADELPHIA, PA 19124-3808
(215) 289-4434
(215) 289-7442
Mailing address
1331 E WYOMING AVE, SUITE 3090, PHILADELPHIA, PA 19124-3808
(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
08/04/2008
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