Provider Demographics
NPI:1518122845
Name:MERAM, ANDREW (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:MERAM
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9880 E GRAND RIVER AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-1948
Mailing Address - Country:US
Mailing Address - Phone:810-227-2626
Mailing Address - Fax:810-227-8532
Practice Address - Street 1:9880 E GRAND RIVER AVE STE 150
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-1948
Practice Address - Country:US
Practice Address - Phone:810-227-2626
Practice Address - Fax:810-227-8532
Is Sole Proprietor?:No
Enumeration Date:2008-07-25
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA302017204E00000X
MI29016012181223S0112X, 1223S0112X
NYP65627122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No122300000XDental ProvidersDentist