Individual
MICHAEL P MESAROS
Active
Individual
MICHAEL P MESAROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301026069
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0G30089
BCBSM GROUP ID
—
01
—
0G36036
MEDICARE GROUP ID
—
01
—
1427090976
GROUP NPI
—
05
—
4156171
—
MI
01
—
CA3610
RAILROAD MEDICARE
—
Enumeration date
09/19/2005
Last updated
03/17/2018
Update your record
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