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NPI Code Detail

MEDICARE: DR. DELIA R EBUEN-MERCADO MD

MEDICARE: DR. DELIA R EBUEN-MERCADO MD
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
1207Q00000XFamily Medicine Physician4301056778MI

Other Identifiers

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

General Provider Information

NPI Number : 1629170444
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DELIA R EBUEN-MERCADO MD
Provider Business Mailing Address
First Line : 3495 S CENTER RD
Second Line :
City : BURTON
State : MI
Zip : 48519-1455
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4154 W VIENNA RD
Second Line :
City : CLIO
State : MI
Zip : 48420-2809
Country : US
Telephone Number : 810-686-3747
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2006
Last Update Date : 06/26/2025

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