Healthcare Provider Details

I. General information

NPI: 1154548600
Provider Name (Legal Business Name): ANTHONY JOSEPH MERAM D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39595 W 10 MILE RD STE 103
NOVI MI
48375-2948
US

IV. Provider business mailing address

890 WOLVERINE DR
WOLVERINE LAKE MI
48390-2377
US

V. Phone/Fax

Practice location:
  • Phone: 248-722-0108
  • Fax: 248-856-4796
Mailing address:
  • Phone: 734-462-0340
  • Fax: 734-462-0344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number5101016952
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: