Organization
LANSING HERNIA CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES E. MCGILLICUDDY M.D. (PRESIDENT)
(517) 372-9880
Entity
Organization
Contact information
Practice address
901 E MOUNT HOPE AVE, LANSING, MI 48910-3207
(517) 372-9880
(517) 372-9882
Mailing address
901 E MOUNT HOPE AVE, LANSING, MI 48910-3207
(517) 372-9880
(517) 372-9882
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
JM026995
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200000002374
PHYSICIANS HEALTH PLAN
MI
Enumeration date
01/07/2008
Last updated
05/19/2008
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