Provider Demographics
NPI:1053817494
Name:DANIEL R MESKO DO PC
Entity Type:Organization
Organization Name:DANIEL R MESKO DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:MESKO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-267-0200
Mailing Address - Street 1:2815 S PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910
Mailing Address - Country:US
Mailing Address - Phone:517-267-0200
Mailing Address - Fax:517-267-1877
Practice Address - Street 1:2815 S PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910
Practice Address - Country:US
Practice Address - Phone:517-267-0200
Practice Address - Fax:517-267-1877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-04
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101022905207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Single Specialty