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General NPI Number Information
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NPI Number | 1699022574
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Entity Type | Individual
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Provider Name | RENARD MERCURIO L. AC.
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Gender | Male
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Dates
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Enumeration Date | 08/09/2012
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Last Update Date | 08/09/2012
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Provider Practice Location Address
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Address Line | 1112 HARDING PL SUITE # 100
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City | CHARLOTTE
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State | NC
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Zip | 28204-2896
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Country | US
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Telephone | 704-706-7824
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Fax |
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Provider Business Mailing Address
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Address Line | 1112 HARDING PL SUITE # 100
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City | CHARLOTTE
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State | NC
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Zip | 28204-2896
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Country | US
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Telephone | 704-706-7824
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Fax |
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 554
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License Number State | NC
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