Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301055452 | MI |
N | 111NI0900X | Internist | 4301055452 | MI |
Y | 207RC0000X | Internist - Cardiovascular Disease | 4301055452 | MI |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 4301055452 | MI |
NPI | 1134103542 |
---|---|
Provider Name | Dr. Marc Daniel Meissner |
First Address | Southfield, MI 48075-2081 |
Second Address | Southfield, MI 48075-2081 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2005 |
Last Update Date | 08/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4381344 | (05) | MI |
A65097 | (02) |