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2909 E Grand River Ave Ste 102 Lansing MI 48912-4335 | |
(517) 364-8670 | |
(517) 364-8671 |
Full Name | |
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Speciality | Internal Medicine |
Location | 2909 E Grand River Ave Ste 102, Lansing, Michigan |
Authorized Official Name and Position | Misty Gunter Russian (SUPERVISOR, PROVIDER ENROLLMENT) |
Authorized Official Contact | 5172536308 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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8175 Reliable Pkwy Chicago IL 60686-0081 Ph: (517) 364-8670 | 2909 E Grand River Ave Ste 102 Lansing MI 48912-4335 Ph: (517) 364-8670 |
NPI Number | 1407494768 |
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Provider Enumeration Date | 12/18/2019 |
Last Update Date | 03/27/2024 |
Medicare PECOS PAC ID | 6709799166 |
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Medicare Enrollment ID | O20200403002736 |
Identifier | Type | State | Issuer |
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1407494768 | NPI | - | NPPES |
Provider Name | Nicholas L Minnaar |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1851517619 PECOS PAC ID: 9830275742 Enrollment ID: I20080318000459 |
Provider Name | Jeremiah G Lopez |
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Provider Type | Practitioner - Geriatric Medicine |
Provider Identifiers | NPI Number: 1306134085 PECOS PAC ID: 6204051246 Enrollment ID: I20140707000693 |
Provider Name | Chelsea R Jensen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831565886 PECOS PAC ID: 2769788322 Enrollment ID: I20160308000396 |
Provider Name | Laura M Hillard |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235696436 PECOS PAC ID: 6103168117 Enrollment ID: I20190423001207 |
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 | |