Provider Demographics
NPI:1306838776
Name:MERCER, NANCI MARGUERITE (MD)
Entity Type:Individual
Prefix:
First Name:NANCI
Middle Name:MARGUERITE
Last Name:MERCER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 OLD RIVER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-9505
Mailing Address - Country:US
Mailing Address - Phone:661-663-6429
Mailing Address - Fax:661-663-6041
Practice Address - Street 1:500 OLD RIVER RD STE 200
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9505
Practice Address - Country:US
Practice Address - Phone:661-663-6429
Practice Address - Fax:661-663-6041
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010664072085R0202X
OH350811062085R0202X
MA2302372085R0202X
CAC1687452085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2400833Medicaid
MI1306838776Medicaid
H17027Medicare UPIN
4091709Medicare ID - Type Unspecified