MEDICARE: INEZ MERCER

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	390200000X	Student in an Organized Health Care Education/Training Program
2	104100000X	Social Worker	26658	MD

General Provider Information

NPI Number	:	1689223547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INEZ MERCER

Provider Business Mailing Address
First Line	:	1002 SITHEAN WAY
Second Line	:
City	:	GLEN BURNIE
State	:	MD
Zip	:	21060-8391
Country	:	US
Telephone Number	:	703-615-4077
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 E FORT AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21230-4628
Country	:	US
Telephone Number	:	443-708-7673
Fax Number	:

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

Provider Enumeration Date	:	09/04/2019
Last Update Date	:	07/24/2023

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Directions to “ INEZ MERCER ” Practice Location

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