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General NPI Number Information
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NPI Number | 1801856141
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Entity Type | Individual
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Provider Name | OGUBAY TEKIE MESMER MD
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Gender | Male
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | 61 N ST JOSEPH AVE
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City | NILES
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State | MI
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Zip | 49120
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Country | US
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Telephone | 269-684-6777
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Fax | 269-683-5384
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Provider Business Mailing Address
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Address Line | 24 N SAINT JOSEPH AVE STE F1
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City | NILES
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State | MI
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Zip | 49120-2263
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Country | US
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Telephone | 269-684-6777
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Fax | 269-683-5384
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 4301079120
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License Number State | MI
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