Provider Demographics
NPI:1831327246
Name:MENDONCA, DERCIO ARAUJO (MD)
Entity type:Individual
Prefix:DR
First Name:DERCIO
Middle Name:ARAUJO
Last Name:MENDONCA
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:535 S BURDICK ST
Mailing Address - Street 2:SUITE 160
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5294
Mailing Address - Country:US
Mailing Address - Phone:269-388-5864
Mailing Address - Fax:269-388-5211
Practice Address - Street 1:535 S BURDICK ST
Practice Address - Street 2:SUITE 160
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5294
Practice Address - Country:US
Practice Address - Phone:269-388-5864
Practice Address - Fax:269-388-5211
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2023-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301107790207RC0200X, 207RP1001X
PAMT194771390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program