De Meireles, Mario Jc

De Meireles, Mario Jc is an individual health care provider with primary practice located at 23874 Kean St , Dearborn MI 48124-1851. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is his primary health care specialty. De Meireles, Mario Jc can be contacted via phone (313) 359-0801.

Contact Information

Primary practice address
23874 Kean St Dearborn MI 48124-1851
Phone: (313) 359-0801
Fax: (313) 359-2674
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 4301061758 Michigan
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 4301061758 Michigan

Profile Details

NPI number 1255335097
LBN Legal business name De Meireles, Mario Jc
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Mar 31st, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255335097 NPPES
Michigan MEDICAID 3326713 10

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