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
2510 KERRY ST STE 200, LANSING, MI 48912
(517) 913-7020
(517) 913-7022
Mailing address
2510 KERRY ST STE 200, LANSING, MI 48912-3671
(517) 913-7020
(517) 913-7022
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200000000593
PHYSICIANS HEALTH PLAN
MI
01
—
700C313280
BCN
MI
Enumeration date
06/27/2007
Last updated
08/02/2018
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