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Organization
MICHIGAN STATE UNIVERSITY
Active
Organization
MICHIGAN STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RELANDA PRICE (LEAD ENROLLMENT COORDINATOR)
(517) 884-2976
Entity
Organization
Contact information
Practice address
1200 E MICHIGAN AVE, STE 145, LANSING, MI 48912-1837
(517) 364-5440
(517) 364-5466
Mailing address
804 SERVICE RD STE A109B, EAST LANSING, MI 48824-7015
(517) 364-5440
(517) 364-5409
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
207SG0201X
Clinical Genetics (M.D.) Physician
—
NULL
207SG0201X
Clinical Genetics (M.D.) Physician
—
—
208000000X
Pediatrics Physician
4301050648
MI
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
NULL
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
—
2080P0202X
Pediatric Cardiology Physician
—
NULL
2080P0202X
Pediatric Cardiology Physician
—
—
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
—
NULL
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
—
—
2080P0208X
Pediatric Infectious Diseases Physician
—
NULL
2080P0208X
Pediatric Infectious Diseases Physician
—
—
2080P0214X
Pediatric Pulmonology Physician
—
NULL
2080P0214X
Pediatric Pulmonology Physician
—
—
2080P0216X
Pediatric Rheumatology Physician
—
NULL
2080P0216X
Pediatric Rheumatology Physician
—
—
Other
Enumeration date
05/22/2006
Last updated
05/15/2023
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