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General NPI Number Information
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NPI Number | 1376500330
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Entity Type | Individual
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Provider Name | ROY JUSTIN MELAND D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 02/27/2024
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Provider Practice Location Address
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Address Line | 2399 HOUGHTON HOLLOW DR
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City | LANSING
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State | MI
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Zip | 48911-8418
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Country | US
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Telephone | 517-855-1795
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10
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City | MASON
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State | MI
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Zip | 48854-0010
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 5101012830
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License Number State | MI
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