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NPI Code Detail

MEDICARE: TYLER DRAKE MENGE MD

MEDICARE: TYLER DRAKE MENGE 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
1207N00000XDermatology Physician4301501739MI
2207ZD0900XDermatopathology (Pathology) Physician4301501739MI

General Provider Information

NPI Number : 1922461235
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER DRAKE MENGE MD
Provider Business Mailing Address
First Line : 4444 W BRISTOL RD STE 150
Second Line :
City : FLINT
State : MI
Zip : 48507-3161
Country : US
Telephone Number : 833-322-3376
Fax Number :
Provider Business Practice Location Address
First Line : 2720 FAIRVIEW AVE N STE 200
Second Line :
City : ROSEVILLE
State : MN
Zip : 55113-1306
Country : US
Telephone Number : 651-633-6883
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2016
Last Update Date : 03/06/2026

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Directions to “ TYLER DRAKE MENGE MD” Practice Location

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