Provider Demographics
NPI:1023568599
Name:MERCER, CHISHA
Entity Type:Individual
Prefix:MS
First Name:CHISHA
Middle Name:
Last Name:MERCER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 ROSWELL RD APT 21B7
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-3062
Mailing Address - Country:US
Mailing Address - Phone:678-373-7565
Mailing Address - Fax:
Practice Address - Street 1:270 CARPENTER DR STE 400
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4933
Practice Address - Country:US
Practice Address - Phone:678-460-0345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program