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Organization

MICHIGAN STATE UNIVERSITY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RELANDA PRICE (OPERATIONS COORDINATOR)
(517) 884-2976
Entity
Organization

Contact information

Practice address
1600 W GRAND RIVER AVE, STE 2, OKEMOS, MI 48864-2394
(517) 349-6560
(517) 348-5796
Mailing address
463 E CIRCLE DR, EAST LANSING, MI 48824-7500
(517) 884-6546
(517) 432-9460

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
207Q00000X
Family Medicine Physician
207SG0201X
Clinical Genetics (M.D.) Physician
5101011076
MI
207SG0201X
Clinical Genetics (M.D.) Physician
207XP3100X
Pediatric Orthopaedic Surgery Physician
5101019945
MI
208000000X
Pediatrics Physician
Primary
2080P0208X
Pediatric Infectious Diseases Physician
208100000X
Physical Medicine & Rehabilitation Physician
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
208800000X
Urology Physician
2088P0231X
Pediatric Urology Physician

Other

Enumeration date
10/23/2006
Last updated
01/20/2026
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