Organization
PLASTIC AND RECONSTRUCTIVE EYE SURGERY PC
Active
Organization
PLASTIC AND RECONSTRUCTIVE EYE SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA LYNN MELDRUM M.D. (OWNER PRESIDENT)
(616) 942-6687
Entity
Organization
Contact information
Practice address
2757 LEONARD ST NE, GRAND RAPIDS, MI 49525-5807
(616) 942-6687
(616) 942-9797
Mailing address
2757 LEONARD ST NE, GRAND RAPIDS, MI 49525-5807
(616) 942-6687
(616) 942-9797
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180D117010
BCBSM
MI
01
—
DC7010
RAILROAD MEDICARE
MI
Enumeration date
06/10/2006
Last updated
06/02/2008
Update your record
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