Individual
DR. MICHAEL WALLACE MESHAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3719 DAUPHIN STREET, 5TH FLOOR, MOBILE, AL 36608-1753
(251) 625-6896
(251) 625-6897
Mailing address
29653 ANCHOR CROSS BLVD, DAPHNE, AL 36526-9594
(251) 625-6896
(251) 625-6897
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
7158
AL
207RX0202X
Medical Oncology Physician
7158
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009941786
—
AL
05
—
009941787
—
AL
05
—
009941788
—
AL
05
—
051513708
—
AL
05
—
222887
—
AL
01
—
P00377085
RAILROAD MEDICARE
AL
Enumeration date
05/18/2006
Last updated
10/27/2021
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