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General NPI Number Information
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NPI Number | 1013131812
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Entity Type | Organization
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Legal Business Name | MARC D. MEISSNER , MD, CM, PLLC
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 05/15/2012
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Provider Practice Location Address
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Address Line | 25270 SOUTHWOOD DR
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2081
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Country | US
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Telephone | 248-559-1942
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Fax |
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Provider Business Mailing Address
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Address Line | 25270 SOUTHWOOD DR
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2081
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Country | US
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Telephone | 248-559-1942
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARC D. MEISSNER
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Credential | MD
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Telephone | 313-966-1154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 4301055452
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License Number State | MI
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