Individual
ERLINDA PENALOSA MERCADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
PO BOX 351, MIDDLETOWN, CT 06457-7023
(860) 395-5042
(860) 395-5058
Mailing address
2000 CHAMBERS ROAD, CARO, MI 48723-9296
(989) 673-3191
(989) 673-0064
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
64604
CT
2084P0800X
Psychiatry Physician
83466
SC
2084P0800X
Psychiatry Physician
EM031514
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104866882
—
MI
01
—
2606386671
BLUE CROSS BLUE SHIELD
MI
01
—
P00027113
RAILROAD MEDICARE
MI
Enumeration date
08/17/2006
Last updated
01/13/2025
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