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Individual

DR. JOHN M DYSART

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3220 DISCOVERY DRIVE, SUITE 210, LANSING, MI 48910
(517) 484-0004
(517) 484-7241
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
2080P0202X
Pediatric Cardiology Physician
Primary
JD063672
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
85305
BLUE CARE NETWORK
MI
05
L3338287
MI
Enumeration date
08/25/2005
Last updated
07/20/2023
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