Healthcare Provider Details

I. General information

NPI: 1053943928
Provider Name (Legal Business Name): MSU HEALTH CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2020
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4660 S HAGADORN RD STE 270
EAST LANSING MI
48823-5353
US

IV. Provider business mailing address

4660 S HAGADORN RD STE 315
EAST LANSING MI
48823-5353
US

V. Phone/Fax

Practice location:
  • Phone: 517-353-8122
  • Fax: 517-432-3713
Mailing address:
  • Phone: 517-353-8122
  • Fax: 517-432-3713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number
License Number State

VIII. Authorized Official

Name: RELANDA PRICE
Title or Position: OPERATIONS COORDINATOR
Credential:
Phone: 517-884-2976