Individual
DR. MODESTO G MERCADO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
450 W CHEW ST, SUITE 409, ALLENTOWN, PA 18102-3434
(610) 770-3130
(610) 770-3452
Mailing address
421 W CHEW ST, ALLENTOWN, PA 18102-3406
(610) 776-5100
(610) 663-3113
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD030130L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007084190
—
PA
Enumeration date
11/08/2005
Last updated
07/09/2007
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