Individual
JANE GUDAKUNST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
804 SERVICE ROAD, ROOM A109, EAST LANSING, MI 48824-7038
(517) 355-1300
(517) 355-1710
Mailing address
804 SERVICE ROAD, ROOM A109, EAST LANSING, MI 48824-7038
(517) 355-1300
(517) 355-1710
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301095342
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629309067
—
MI
Enumeration date
01/25/2010
Last updated
07/27/2012
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