| Southside Medical Center Inc | |
|
5525 S Martin Luther King Jr Blvd Lansing MI 48911-3546 | |
| (517) 913-3888 | |
| Not Available |
| Full Name | Southside Medical Center Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5525 S Martin Luther King Jr Blvd, Lansing, Michigan |
| Authorized Official Name and Position | Douglas Vanderjact (OWNER) |
| Authorized Official Contact | 5179133888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southside Medical Center Inc 5525 S Martin Luther King Jr Blvd Lansing MI 48911-3546 Ph: (517) 913-3888 | Southside Medical Center Inc 5525 S Martin Luther King Jr Blvd Lansing MI 48911-3546 Ph: (517) 913-3888 |
| NPI Number | 1245636885 |
|---|---|
| Provider Enumeration Date | 11/10/2014 |
| Last Update Date | 11/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245636885 | NPI | - | NPPES |
| 1730121880 | Other | MI | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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