Organization
DEMELLO MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID WILLIAM DEMELLO DO (OWNER)
(586) 228-0600
Entity
Organization
Contact information
Practice address
39379 GARFIELD RD, CILNTON TOWNSHIP, MI 48038
(586) 228-0600
(586) 228-1839
Mailing address
39379 GARFIELD RD, CILNTON TOWNSHIP, MI 48038
(586) 228-0600
(586) 228-1839
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
DD007358
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4939290
—
MI
Enumeration date
11/01/2006
Last updated
10/15/2013
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