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General NPI Number Information
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NPI Number | 1699018424
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Entity Type | Individual
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Provider Name | MARIE LILU DUAN MESERVY
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Gender | Female
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Dates
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Enumeration Date | 03/29/2013
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 975 KIRMAN AVE # 111
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City | RENO
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State | NV
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Zip | 89502-0993
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Country | US
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Telephone | 775-328-1429
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Fax |
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Provider Business Mailing Address
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Address Line | 975 KIRMAN AVE # 111
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City | RENO
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State | NV
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Zip | 89502-0993
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Country | US
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Telephone | 775-328-1429
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | S1390
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 19203
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License Number State | NV
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