MEDICARE: DR. MELEK RONALD KAYSER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0122X	Plastic and Reconstructive Surgery Physician	4301053195	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	0500536	OTHER	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	P93479	OTHER	BCN

General Provider Information

NPI Number	:	1588657712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELEK RONALD KAYSER MD

Provider Business Mailing Address
First Line	:	29167 JEFFERSON AVE
Second Line	:
City	:	SAINT CLAIR SHORES
State	:	MI
Zip	:	48081-1331
Country	:	US
Telephone Number	:	586-776-3223
Fax Number	:	586-776-6670

Provider Business Practice Location Address
First Line	:	29167 JEFFERSON AVE
Second Line	:
City	:	SAINT CLAIR SHORES
State	:	MI
Zip	:	48081-1331
Country	:	US
Telephone Number	:	586-776-3223
Fax Number	:	586-776-6670

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	02/08/2017

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