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General NPI Number Information
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NPI Number | 1023246048
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Entity Type | Individual
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Provider Name | MIGNON MERCADO DE LEON MD
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Gender | Female
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Dates
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Enumeration Date | 06/29/2009
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Last Update Date | 01/10/2022
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Provider Practice Location Address
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Address Line | 1330 POWELL ST SUITE 409
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City | NORRISTOWN
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State | PA
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Zip | 19401-3353
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Country | US
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Telephone | 610-277-0964
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Fax |
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Provider Business Mailing Address
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Address Line | 8205 W WARM SPRINGS RD STE 210
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City | LAS VEGAS
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State | NV
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Zip | 89113-3646
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Country | US
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Telephone | 702-616-7660
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Fax | 702-616-7713
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MT 194898
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License Number State | PA
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