Organization
MICHIGAN SLEEP DIAGNOSTIC CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANGASWAMI PRAKASH (PRESIDENT)
(517) 917-7835
Entity
Organization
Contact information
Practice address
2000 SPRING ARBOR RD, SUITE B, JACKSON, MI 49203-2887
(517) 962-5220
(517) 962-5221
Mailing address
2000 SPRING ARBOR RD, SUITE B, JACKSON, MI 49203-2887
(517) 962-5220
(517) 962-5221
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0C80005
BCBS
—
05
—
1053554469
—
MI
Enumeration date
04/14/2009
Last updated
01/11/2010
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