| Mario De Meireles Md Mhsa Pc | |
|
9260 Fellows Creek Dr Plymouth MI 48170-6354 | |
| (734) 462-0340 | |
| (734) 462-0344 |
| Full Name | Mario De Meireles Md Mhsa Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9260 Fellows Creek Dr, Plymouth, Michigan |
| Authorized Official Name and Position | Mario De Meireles (PRESIDENT) |
| Authorized Official Contact | 2483027686 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mario De Meireles Md Mhsa Pc 9260 Fellows Creek Dr Plymouth MI 48170-6354 Ph: (734) 462-0340 | Mario De Meireles Md Mhsa Pc 9260 Fellows Creek Dr Plymouth MI 48170-6354 Ph: (734) 462-0340 |
| NPI Number | 1184895849 |
|---|---|
| Provider Enumeration Date | 03/20/2008 |
| Last Update Date | 10/27/2020 |
| Medicare PECOS PAC ID | 5991883753 |
|---|---|
| Medicare Enrollment ID | O20080418000126 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184895849 | NPI | - | NPPES |
| 4301061758 | Other | MI | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301061758 (Michigan) | Primary |
| Provider Name | Mario J De Meireles |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255335097 PECOS PAC ID: 8921993163 Enrollment ID: I20060717000146 |
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