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Diagnostic Ultrasound >> Radiology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1366491664

Individual Registrant:
Gender: M
Not Sole Proprietor

Location and contact information for practice:
4660 S HAGADORN RD #600 EAST LANSING, MI 48823-5376 US
Tel: 517-884-9000  Fax: 517-884-0000

Contact information for business:
804 SERVICE RD A201 EAST LANSING, MI 48824-7015 US
Tel: 517-884-2976  Fax: 517-432-3928

Registration Information:
NPI: 1366491664
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2085U0001XAllopathic & Osteopathic Physicians
Diagnostic Ultrasound

Legacy codes, insurance codes and state license numbers:



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