Provider Demographics
NPI:1801878947
Name:OBEIME, MERCY (MD)
Entity type:Individual
Prefix:DR
First Name:MERCY
Middle Name:
Last Name:OBEIME
Suffix:
Gender:
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:PO BOX 781008
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1008
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-780-3345
Practice Address - Street 1:7855 S EMERSON AVE STE P
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8669
Practice Address - Country:US
Practice Address - Phone:317-787-9471
Practice Address - Fax:317-781-7347
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01044326A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200108480AMedicaid
IN200108480AMedicaid