Individual
DR. JOSE EDMUNDO MANRIQUE MERCADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4747 ARAPAHOE AVE, BOULDER, CO 80303-1131
(303) 415-7610
(303) 415-7618
Mailing address
PO BOX 9049, BOULDER, CO 80301-9049
(303) 415-8940
(303) 425-9259
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DR.0050935
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90120078
—
CO
Enumeration date
02/22/2011
Last updated
09/27/2024
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