| Elctrodiagnostic Medicine Consultants, Pllc | |
|
1515 Lake Lansing Rd Suite F-1 Lansing MI 48912-3753 | |
| (517) 374-1055 | |
| (517) 374-1061 |
| Full Name | Elctrodiagnostic Medicine Consultants, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Clinical Neurophysiology |
| Location | 1515 Lake Lansing Rd, Lansing, Michigan |
| Authorized Official Name and Position | Frederick Michael Vincent (OWNER/PHYSICIAN) |
| Authorized Official Contact | 5173741055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elctrodiagnostic Medicine Consultants, Pllc 1515 Lake Lansing Rd Suite F-1 Lansing MI 48912-3753 Ph: (517) 374-1055 | Elctrodiagnostic Medicine Consultants, Pllc 1515 Lake Lansing Rd Suite F-1 Lansing MI 48912-3753 Ph: (517) 374-1055 |
| NPI Number | 1477710135 |
|---|---|
| Provider Enumeration Date | 05/20/2008 |
| Last Update Date | 05/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477710135 | NPI | - | NPPES |
| 1687260 | Medicaid | MI | |
| 0331291 | Other | MI | MEDICARE ID-TYPE UNSPECIFIED |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | 4301035133 (Michigan) | Primary |
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