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General NPI Number Information
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NPI Number | 1619313327
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Entity Type | Individual
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Provider Name | NURIA E ROSA MERCADAL M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/21/2013
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 1104 E GRACE ST
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City | RENSSELAER
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State | IN
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Zip | 47978-3211
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Country | US
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Telephone | 219-866-5141
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Fax | 219-866-3234
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Provider Business Mailing Address
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Address Line | PO BOX 781076
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City | DETROIT
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State | MI
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Zip | 48278-1076
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Country | US
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Telephone | 317-528-4800
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Fax | 317-865-1479
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 11017056A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01076866A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 01076866A
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License Number State | IN
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