Individual
MR. BRIAN JAMES TSACOUMANGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2900 HANNAH BLVD STE 114, EAST LANSING, MI 48823-5380
(517) 364-8080
(517) 364-8088
Mailing address
5689 FRANCESCA LN, SHELBY TOWNSHIP, MI 48316-5752
(586) 295-0734
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5315090741
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346739224
—
MI
Enumeration date
05/06/2018
Last updated
04/01/2024
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