Provider Demographics
NPI:1851338156
Name:MEISEL, RONALD L (DO)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:L
Last Name:MEISEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16570 19 MILE MILE RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1106
Mailing Address - Country:US
Mailing Address - Phone:586-226-7400
Mailing Address - Fax:586-226-2970
Practice Address - Street 1:16570 19 MILE RD
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-1106
Practice Address - Country:US
Practice Address - Phone:586-226-7400
Practice Address - Fax:586-226-2970
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRM010735207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI26-3563195OtherITIN
MI26-3563195OtherITIN