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Individual

DR. MARISSA MARICEL ARMAMENTO MERCADO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
26 W JACKSON COMMONS DR, HOSCHTON, GA 30548-1897
(770) 848-9190
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
(770) 219-8440

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
067505
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003124550A
GA
01
20208I2361
MEDICARE PTAN#
GA
Enumeration date
06/29/2009
Last updated
03/22/2021
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