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4415 N Grand River Ave Lansing MI 48906-2614 | |
(517) 323-3646 | |
(517) 323-3648 |
Full Name | |
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Speciality | Family Medicine |
Location | 4415 N Grand River Ave, Lansing, Michigan |
Authorized Official Name and Position | Shannon G Wiggins (OWNER) |
Authorized Official Contact | 5173233646 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2310 E Michigan Ave Lansing MI 48912-4018 Ph: (517) 346-7628 | 4415 N Grand River Ave Lansing MI 48906-2614 Ph: (517) 323-3646 |
NPI Number | 1124135116 |
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Provider Enumeration Date | 08/24/2006 |
Last Update Date | 04/09/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124135116 | NPI | - | NPPES |
0853310215 | Other | MI | BCN |
5101013727 | Other | MI | DR WIGGINS LICENSE # |
4924592 | Medicaid | MI | |
0853310215 | Other | MI | BCBS |
1295744530 | Other | MI | DR WIGGINS NPI# |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 5101013727 (Michigan) | Primary |
Mi Post Acute Specialists Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 707 Armstrong Rd, Lansing, MI 48911 Phone: 800-411-6768 | |
Lansing Family Physicians Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4202 Collins Rd, Suite 115, Lansing, MI 48910 Phone: 517-484-4520 Fax: 517-484-3930 | |
Ingham County Health Department Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5303 S Cedar St, Lansing, MI 48911 Phone: 517-887-4311 | |