Individual
MYRNA R MENESES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1414 W FAIR AVE, SUITE 108, MARQUETTE, MI 49855-2675
(906) 225-3936
Mailing address
1414 W FAIR AVE, SUITE 108, MARQUETTE, MI 49855-2675
(906) 225-3936
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
4301054887
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0305210272
BLUE CROSS BLUE SHIELD MI
MA
05
—
102593507
—
MI
Enumeration date
05/24/2006
Last updated
12/13/2011
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