MEDICARE: ADELAIDA MERKER D.O., P.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	207Q00000X	Family Medicine Physician	OS040658L	PA

Other Identifiers

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

General Provider Information

NPI Number	:	1235162967
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADELAIDA MERKER D.O., P.C

Provider Business Mailing Address
First Line	:	842 RED LION RD
Second Line	:	UNIT 7
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-1475
Country	:	US
Telephone Number	:	215-677-6616
Fax Number	:	215-677-6225

Provider Business Practice Location Address
First Line	:	842 RED LION RD
Second Line	:	UNIT 7
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-1475
Country	:	US
Telephone Number	:	215-677-6616
Fax Number	:	215-677-6225

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ADELAIDA MERKER
Credential	:	D.O.
Telephone Number	:	215-677-6616

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	06/29/2010

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