Provider Demographics
NPI:1821180530
Name:WILLIAM C MERCER
Entity Type:Organization
Organization Name:WILLIAM C MERCER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:MERCER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-232-5725
Mailing Address - Street 1:58 16TH ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-3660
Mailing Address - Country:US
Mailing Address - Phone:302-232-5725
Mailing Address - Fax:304-233-0698
Practice Address - Street 1:58 16TH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3660
Practice Address - Country:US
Practice Address - Phone:302-232-5725
Practice Address - Fax:304-233-0698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV12007207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810002423Medicaid
WV3810002423Medicaid
WV9311191Medicare PIN