| Dr. Max E. Mercado Practice, Llc | |
|
1331 E Wyoming Ave Suite 3090 Philadelphia PA 19124-3808 | |
| (215) 289-4434 | |
| (215) 289-7442 |
| Full Name | Dr. Max E. Mercado Practice, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1331 E Wyoming Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Max Enrique Mercado (OWNER) |
| Authorized Official Contact | 2152894434 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Max E. Mercado Practice, Llc 1331 E Wyoming Ave Suite 3090 Philadelphia PA 19124-3808 Ph: (215) 289-4434 | Dr. Max E. Mercado Practice, Llc 1331 E Wyoming Ave Suite 3090 Philadelphia PA 19124-3808 Ph: (215) 289-4434 |
| NPI Number | 1629160742 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 08/04/2008 |
| Medicare PECOS PAC ID | 9739251315 |
|---|---|
| Medicare Enrollment ID | O20080627000063 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629160742 | NPI | - | NPPES |
| 0019063200001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Pennsylvania) | Primary |
| Provider Name | Max E Mercado |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336151182 PECOS PAC ID: 8325008154 Enrollment ID: I20041015000087 |
| Provider Name | Jose A Bossbaly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376551101 PECOS PAC ID: 3870515125 Enrollment ID: I20051229000636 |
| Provider Name | Nimidia Oviedo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1770592438 PECOS PAC ID: 3072529197 Enrollment ID: I20060228000110 |
| Provider Name | Delia M Larrauri |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942410790 PECOS PAC ID: 0749467926 Enrollment ID: I20110616000172 |
| Provider Name | Alejandro Garcia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578195756 PECOS PAC ID: 4284087347 Enrollment ID: I20240125001955 |
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