Registry details
Type
Individual
Primary specialty
Internal Medicine, Critical Care Medicine
Enumerated
Aug 29, 2006
License(s)
4301054596 (MI), 4301054596 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 405 W GREENLAWN AVE SUITE 130 | Lansing, MI 48910-2898 | 517-574-5645 |
| MAILING | 405 W GREENLAWN AVE SUITE 105 | Lansing, MI 48910 | 517-574-5645 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.