Provider Demographics
NPI:1184731820
Name:MERCER, PHILIP WERNER (MD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:WERNER
Last Name:MERCER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 TRADEWINDS DR
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-1252
Mailing Address - Country:US
Mailing Address - Phone:772-589-2992
Mailing Address - Fax:772-581-8331
Practice Address - Street 1:5115 TRADEWINDS DR
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32963-1252
Practice Address - Country:US
Practice Address - Phone:772-589-2992
Practice Address - Fax:772-581-8331
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0061603207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME0061603OtherLICENSE
15252XMedicare ID - Type Unspecified
F33584Medicare UPIN