Healthcare Provider Details

I. General information

NPI: 1467670539
Provider Name (Legal Business Name): ABBIE MERCURIO A.P., M.AC., L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 08/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 HARDING PL SUITE # 100
CHARLOTTE NC
28204-2864
US

IV. Provider business mailing address

1112 HARDING PL SUITE # 100
CHARLOTTE NC
28204-2864
US

V. Phone/Fax

Practice location:
  • Phone: 704-370-2447
  • Fax:
Mailing address:
  • Phone: 704-370-2447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberNC333
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP1782
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: