Organization
MCLAREN GREATER LANSING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE THOMPSON (CFO)
(517) 975-7555
Entity
Organization
Contact information
Practice address
3220 DISCOVERY DR STE 200, LANSING, MI 48910-8609
(517) 975-8910
(517) 975-8925
Mailing address
PO BOX 775429, CHICAGO, IL 60677-5429
(517) 975-6000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
5101012213
MI
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700C310570
BLUE CROSS BLUE SHIELD
MI
Enumeration date
01/31/2007
Last updated
11/14/2023
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