Organization
MICHIANA REGIONAL SLEEP DISORDERS CENTER P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT L. PIASECKI DO (PRESIDENT)
(269) 983-3690
Entity
Organization
Contact information
Practice address
3902 STONEGATE PARK, SAINT JOSEPH, MI 49085-9130
(269) 983-3690
(269) 982-5101
Mailing address
3902 STONEGATE PARK, SAINT JOSEPH, MI 49085-9130
(269) 983-3690
(269) 982-5101
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
5101008659
MI
207YS0012X
Sleep Medicine (Otolaryngology) Physician
4301070920
MI
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
5101009750
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700A110350
BCBSM CPC
MI
Enumeration date
01/22/2007
Last updated
04/23/2008
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