Provider Demographics
NPI:1801621677
Name:DUMA, MEAGHAN ELIZABETH
Entity type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:ELIZABETH
Last Name:DUMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEAGHAN
Other - Middle Name:ELIZABETH
Other - Last Name:BRANTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28569 MAPLEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-2184
Mailing Address - Country:US
Mailing Address - Phone:734-334-7362
Mailing Address - Fax:
Practice Address - Street 1:6900 E 10 MILE RD
Practice Address - Street 2:
Practice Address - City:CENTER LINE
Practice Address - State:MI
Practice Address - Zip Code:48015-1168
Practice Address - Country:US
Practice Address - Phone:586-501-3070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851119825171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator