Organization
MARIO DE MEIRELES MD MHSA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIO DE MEIRELES MD (PRESIDENT)
(248) 302-7686
Entity
Organization
Contact information
Practice address
9260 FELLOWS CREEK DR, PLYMOUTH, MI 48170-6354
(734) 462-0340
(734) 462-0344
Mailing address
9260 FELLOWS CREEK DR, PLYMOUTH, MI 48170-6354
(734) 462-0340
(734) 462-0344
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301061758
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301061758
STATE LICENSE
MI
Enumeration date
03/20/2008
Last updated
10/27/2020
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