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NPI Code Detail

MEDICARE: MITCHELL MESZAROS MS, ATC, LAT, CES

MEDICARE:   MITCHELL  MESZAROS  MS, ATC, LAT, CES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer2410NC

General Provider Information

NPI Number : 1164825212
Entity Type Code : Individual
Provider Name (Legal Business Name) : MITCHELL MESZAROS MS, ATC, LAT, CES
Provider Business Mailing Address
First Line : 1105 CRAB ORCHARD DR APT 2B
Second Line :
City : RALEIGH
State : NC
Zip : 27606-3515
Country : US
Telephone Number : 301-641-5540
Fax Number :
Provider Business Practice Location Address
First Line : 1105 CRAB ORCHARD DR APT 2B
Second Line :
City : RALEIGH
State : NC
Zip : 27606-3515
Country : US
Telephone Number : 301-641-5540
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2014
Last Update Date : 10/03/2014

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Directions to “ MITCHELL MESZAROS MS, ATC, LAT, CES” Practice Location

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