Provider Demographics
NPI:1770605404
Name:MERCER, RONALD BRANDT (DO MPH)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:BRANDT
Last Name:MERCER
Suffix:
Gender:M
Credentials:DO MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CRIMSON DRIVE
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-2101
Mailing Address - Country:US
Mailing Address - Phone:302-234-0282
Mailing Address - Fax:
Practice Address - Street 1:ROUTE 141
Practice Address - Street 2:DUPONT MEDICAL CLINIC CRP 700
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19880-0700
Practice Address - Country:US
Practice Address - Phone:302-999-2267
Practice Address - Fax:302-999-3665
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC20002147207Q00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DED83855Medicare UPIN