Organization
PEDIATRIC PHYSICIANS OF LANSING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK D ISREAL (PRESIDENT)
(517) 371-4719
Entity
Organization
Contact information
Practice address
1200 E MICHIGAN AVE, LANSING, MI 48912-1800
(517) 364-5422
(517) 364-5439
Mailing address
DEPT CH 17787, PALATINE, IL 60055-0001
(800) 968-6866
(616) 532-7230
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0P33004
MCARE
MI
01
—
1230630001
WELLNESS
MI
01
—
700C36031
BCBS
MI
01
—
XX00077
HEALTHPLUS
MI
Enumeration date
10/12/2006
Last updated
01/17/2008
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