MEDICARE: LISA A MEILS M.D.

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
1	174400000X	Specialist	4301051255	MI

General Provider Information

NPI Number	:	1396760278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA A MEILS M.D.

Provider Business Mailing Address
First Line	:	155 ROCHDALE DR S
Second Line	:	SUITE A
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-2276
Country	:	US
Telephone Number	:	248-608-0360
Fax Number	:	248-608-0362

Provider Business Practice Location Address
First Line	:	155 ROCHDALE DR S
Second Line	:	SUITE A
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-2276
Country	:	US
Telephone Number	:	248-608-0360
Fax Number	:	248-608-0362

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	11/18/2022

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