Organization
MICHIGAN STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RELANDA PRICE (LEAD ENROLLMENT COORDINATOR)
(517) 884-2976
Entity
Organization
Contact information
Practice address
463 E CIRCLE DR, EAST LANSING, MI 48824-7500
(517) 353-4660
Mailing address
804 SERVICE RD STE A109B, EAST LANSING, MI 48824-7015
(517) 884-6546
(517) 432-9460
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
225100000X
Physical Therapist
—
—
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/18/2006
Last updated
03/15/2023
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