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Organization
MICHIANA REGIONAL SLEEP DISORDERS CENTER P.C.
Active
Organization
MICHIANA REGIONAL SLEEP DISORDERS CENTER P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT L. PIASECKI DO (PRESIDENT)
(269) 983-3690
Entity
Organization
Contact information
Practice address
3902 STONEGATE PARK, SAINT JOSEPH, MI 49085-9130
(269) 983-3690
(269) 982-5101
Mailing address
3902 STONEGATE PARK, SAINT JOSEPH, MI 49085-9130
(269) 983-3690
(269) 982-5101
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
5101008659
MI
207YS0012X
Sleep Medicine (Otolaryngology) Physician
4301070920
MI
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
5101009750
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700A110350
BCBSM CPC
MI
Enumeration date
01/22/2007
Last updated
04/23/2008
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