Provider Demographics
NPI:1316332224
Name:MERCER MEDICAL GROUP
Entity type:Organization
Organization Name:MERCER MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-858-7144
Mailing Address - Street 1:300 CARNEGIE CTR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-6249
Mailing Address - Country:US
Mailing Address - Phone:609-858-7144
Mailing Address - Fax:609-858-7145
Practice Address - Street 1:300 CARNEGIE CTR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6249
Practice Address - Country:US
Practice Address - Phone:609-858-7144
Practice Address - Fax:609-858-7145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization