MEDICARE: DR. JEFFREY MENSAH

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	175F00000X	Naturopath	099.0134116	VT

General Provider Information

NPI Number	:	1679226823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY MENSAH

Provider Business Mailing Address
First Line	:	505 JASPER CT
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20721-7221
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	43097 WOODWARD AVE STE 101
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-5042
Country	:	US
Telephone Number	:	248-798-2942
Fax Number	:	248-858-8411

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

Provider Enumeration Date	:	01/28/2022
Last Update Date	:	02/19/2022

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