Healthcare Provider Details

I. General information

NPI: 1992555270
Provider Name (Legal Business Name): MELISSA CUEVAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 GREENWICH ST
SAGINAW MI
48602-1849
US

IV. Provider business mailing address

1513 GREENWICH ST
SAGINAW MI
48602-1849
US

V. Phone/Fax

Practice location:
  • Phone: 989-341-1113
  • Fax:
Mailing address:
  • Phone: 989-341-1113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: