Individual
ELENA MARIE MEHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
210 N LAFAYETTE ST, SOUTH LYON, MI 48178-2048
(248) 437-1744
Mailing address
210 N LAFAYETTE ST, SOUTH LYON, MI 48178-2048
(248) 437-1744
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301105259
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0020661-01
—
TX
01
—
8160
CHIROPRACTIC LICENSE
TX
01
—
CO6092019 MCD
OLD MEDICAID NUMBER
TX
Enumeration date
07/02/2007
Last updated
05/30/2014
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