Mario de Meireles MD Mhsa PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301061758 Issued in MI

Legal business name

MARIO DE MEIRELES MD MHSA PC

Practice address

9260 Fellows Creek Dr
Plymouth, MI 48170-6354

Phone

(734) 462-0340

Fax

(734) 462-0344

NPI assigned

Mar 20, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mario De Meireles, MDNPI 1255335097

Title

President

Phone

(248) 302-7686

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mario JC De Meireles, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Dearborn, MI
  • NPI 1255335097
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603756800000",
    "number": "1184895849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9260 FELLOWS CREEK DR",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706354",
            "telephone_number": "734-462-0340",
            "fax_number": "734-462-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9260 FELLOWS CREEK DR",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706354",
            "telephone_number": "734-462-0340",
            "fax_number": "734-462-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIO DE MEIRELES MD MHSA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-20",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A",
        "authorized_official_last_name": "DE MEIRELES",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-302-7686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301061758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4301061758",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Manwaring
• Michelle Marek
• Cristina Mares
• Juanita Marie
• Jessica Marinski, OTRL
• Mark C Santamaria DDS PC
• Richard Mark, DO
• Jocelyn A Markowicz, PHD
• Lilia H Markus
• McKeever Marlar

• Internal Medicine Physician in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.