MEDICARE: MECHEL POTROS 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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1730044272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MECHEL POTROS MD

Provider Business Mailing Address
First Line	:	6550 DELILAH RD
Second Line	:
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-5102
Country	:	US
Telephone Number	:	408-394-8809
Fax Number	:

Provider Business Practice Location Address
First Line	:	6550 DELILAH RD
Second Line	:
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-5102
Country	:	US
Telephone Number	:	408-394-8809
Fax Number	:

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

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	12/17/2025

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