Provider Demographics
NPI:1164072633
Name:MESTOKIRDI, MAYSAA
Entity Type:Individual
Prefix:
First Name:MAYSAA
Middle Name:
Last Name:MESTOKIRDI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAYSA
Other - Middle Name:
Other - Last Name:MESTO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6700 MIDDLEBELT RD
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-2039
Mailing Address - Country:US
Mailing Address - Phone:734-629-5092
Mailing Address - Fax:
Practice Address - Street 1:6700 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-2039
Practice Address - Country:US
Practice Address - Phone:734-629-5092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program