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Individual

LITON MECANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10047 CROSSROAD CT SE, CALEDONIA, MI 49316-7316
(616) 685-8450
(616) 458-3526
Mailing address
245 STATE ST SE, GRAND RAPIDS, MI 49503-4328
(616) 685-1808
(616) 685-1850

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301062209
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3415760
MI
05
4155559
MI
05
4181728
MI
05
4186116
MI
05
4208447
MI
05
4212691
MI
05
4555004
MI
05
4749643
MI
05
4878346
MI
05
4879011
MI
Enumeration date
05/18/2006
Last updated
06/29/2009
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