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2909 E Grand River Ave Suite 211 Lansing MI 48912-4300 | |
(517) 364-8686 | |
(517) 364-8685 |
Full Name | |
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Speciality | Family Medicine |
Location | 2909 E Grand River Ave, Lansing, Michigan |
Authorized Official Name and Position | Misty Gunter Russian (SUPERVISOR, PROVIDER ENROLLMENT) |
Authorized Official Contact | 5172536308 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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8175 Reliable Pkwy Chicago IL 60686-3008 Ph: (517) 364-8686 | 2909 E Grand River Ave Suite 211 Lansing MI 48912-4300 Ph: (517) 364-8686 |
NPI Number | 1295788404 |
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Provider Enumeration Date | 05/18/2006 |
Last Update Date | 03/26/2024 |
Identifier | Type | State | Issuer |
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1295788404 | NPI | - | NPPES |
080C361700 | Other | MI | BCBS GROUP NUMBER |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | 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 | |