MEDICARE: GLORIA V MERCADO M.D.

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	208D00000X	General Practice Physician	51934	MA

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
2	412269	OTHER	RI	BC BS OF RI (BLUECHIP)
3	44289	OTHER	MA	CHILDREN'S MEDICAL SP
4	0039507	OTHER	MA	NEIGHBORHOOD HEALTH PLAN
5	0103124	OTHER	MA	UNITEDHEALTHCARE
6	210126	OTHER	RI	BC BS OF RI
7	961245-01	OTHER	MA	NETWORK HEALTH
8	J05037	OTHER	MA	BC BS OF MA

General Provider Information

NPI Number	:	1578628715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLORIA V MERCADO M.D.

Provider Business Mailing Address
First Line	:	387 QUARRY ST
Second Line	:	SUITE 100
City	:	FALL RIVER
State	:	MA
Zip	:	02723-1025
Country	:	US
Telephone Number	:	508-679-8111
Fax Number	:	508-674-5028

Provider Business Practice Location Address
First Line	:	387 QUARRY ST
Second Line	:	SUITE 100
City	:	FALL RIVER
State	:	MA
Zip	:	02723-1025
Country	:	US
Telephone Number	:	508-679-8111
Fax Number	:	508-674-5028

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	01/04/2013

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Directions to “ GLORIA V MERCADO M.D.” Practice Location

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