Provider Demographics
NPI:1629077375
Name:MERCED, DALIA REBECCA (MD)
Entity Type:Individual
Prefix:DR
First Name:DALIA
Middle Name:REBECCA
Last Name:MERCED
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 1:1061 HARMON AVE
Mailing Address - Street 2:STE 1D03
Mailing Address - City:FORT STEWART
Mailing Address - State:GA
Mailing Address - Zip Code:31314-5674
Mailing Address - Country:US
Mailing Address - Phone:912-435-6932
Mailing Address - Fax:
Practice Address - Street 1:1061 HARMON AVE
Practice Address - Street 2:
Practice Address - City:FT STEWART
Practice Address - State:GA
Practice Address - Zip Code:31314-5604
Practice Address - Country:US
Practice Address - Phone:912-435-6932
Practice Address - Fax:912-435-6191
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA036414207ZP0102X
GA36414208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology