| Michigan State University | |
|
463 E Circle Dr East Lansing MI 48824-7500 | |
| (517) 353-4660 | |
| Not Available |
| Full Name | Michigan State University |
|---|---|
| Speciality | Clinic/Center |
| Location | 463 E Circle Dr, East Lansing, Michigan |
| Authorized Official Name and Position | Relanda Price (LEAD ENROLLMENT COORDINATOR) |
| Authorized Official Contact | 5178842976 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michigan State University 804 Service Rd Ste A109b East Lansing MI 48824-7015 Ph: (517) 884-6546 | Michigan State University 463 E Circle Dr East Lansing MI 48824-7500 Ph: (517) 353-4660 |
| NPI Number | 1770646028 |
|---|---|
| Provider Enumeration Date | 12/18/2006 |
| Last Update Date | 03/15/2023 |
| Medicare PECOS PAC ID | 3870405954 |
|---|---|
| Medicare Enrollment ID | O20031218000451 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770646028 | NPI | - | NPPES |
| Provider Name | Stacy S Bull |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619071115 PECOS PAC ID: 4385546878 Enrollment ID: I20040124000051 |
| Provider Name | Saleh A Al Dasouqi |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1710928015 PECOS PAC ID: 8325939234 Enrollment ID: I20040322000793 |
| Provider Name | Paul E Quinlan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376527721 PECOS PAC ID: 5991782427 Enrollment ID: I20040702000269 |
| Provider Name | Michael Bradley Shingles |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1164466223 PECOS PAC ID: 7113966631 Enrollment ID: I20050425001167 |
| Provider Name | Keith G Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811001167 PECOS PAC ID: 6406883842 Enrollment ID: I20050718000953 |
| Provider Name | Lee Ming Li Wang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306870985 PECOS PAC ID: 0749212389 Enrollment ID: I20050906000168 |
| Provider Name | Qaisra Zubair |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265467047 PECOS PAC ID: 9234151473 Enrollment ID: I20051230000541 |
| Provider Name | Joseph R Pernicone |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114975745 PECOS PAC ID: 1254341050 Enrollment ID: I20060424000510 |
| Provider Name | Andrea Amalfitano |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134133762 PECOS PAC ID: 7012917180 Enrollment ID: I20070115000140 |
| Provider Name | Julia B Popenoe |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023089794 PECOS PAC ID: 3173615986 Enrollment ID: I20070824000476 |
| Provider Name | Jonathan Gold |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881602316 PECOS PAC ID: 2860531381 Enrollment ID: I20091123000337 |
| Provider Name | Randolph L Pearson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770687998 PECOS PAC ID: 7810021748 Enrollment ID: I20100814000068 |
| Provider Name | Timothy Paul Spedoske |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750455804 PECOS PAC ID: 8022132190 Enrollment ID: I20100825001077 |
| Provider Name | Farha Z Abbasi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689881781 PECOS PAC ID: 5395938526 Enrollment ID: I20101020001263 |
| Provider Name | Michael T Mangan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144457805 PECOS PAC ID: 2062662760 Enrollment ID: I20121015000310 |
| Provider Name | Christopher Luke Wilcox |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1497963425 PECOS PAC ID: 9739335670 Enrollment ID: I20130918000188 |
| Provider Name | Kristine N Tomlinson-miles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023529427 PECOS PAC ID: 3779849849 Enrollment ID: I20171106000937 |
| Provider Name | Alex M Tomlinson-miles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710498142 PECOS PAC ID: 7517224975 Enrollment ID: I20171121000177 |
| Provider Name | Sheeba Mariam Joseph |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1215293089 PECOS PAC ID: 9537467667 Enrollment ID: I20180710000560 |
| Provider Name | Fawzia Yerima |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578117842 PECOS PAC ID: 3870928898 Enrollment ID: I20200122001627 |
| Provider Name | William James Seydel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326574385 PECOS PAC ID: 2365823267 Enrollment ID: I20220725001346 |
Endodontic Specialists, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2501 Coolidge Rd, Suite 201, East Lansing, MI 48823 Phone: 517-351-0800 Fax: 517-351-3399 | |
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