MEDICARE: AXEL LUIS MERCADO PA C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA3322	FL
2	363A00000X	Physician Assistant	0010-10047	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00129654	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578594065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AXEL LUIS MERCADO PA C

Provider Business Mailing Address
First Line	:	128 LANGDON POINTE DR
Second Line	:
City	:	GARNER
State	:	NC
Zip	:	27529
Country	:	US
Telephone Number	:	305-278-8304
Fax Number	:	252-237-5034

Provider Business Practice Location Address
First Line	:	2130 FOREST HILLS RD W STE B
Second Line	:
City	:	WILSON
State	:	NC
Zip	:	27893-3681
Country	:	US
Telephone Number	:	252-237-2700
Fax Number	:	252-237-5034

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	03/03/2026

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Directions to “ AXEL LUIS MERCADO PA C” Practice Location

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