Individual
DR. MAYO MITSUYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1375 N MAIN ST, LAPEER, MI 48446-1350
(810) 667-7350
Mailing address
130 KERCHEVAL AVE STE 210, GROSSE POINTE FARMS, MI 48236-3798
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5101019835
MI
208VP0014X
Interventional Pain Medicine Physician
5101019835
MI
Other
Enumeration date
04/02/2012
Last updated
08/28/2019
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