Healthcare Provider Details

I. General information

NPI: 1144246745
Provider Name (Legal Business Name): LANSING ANESTHESIA ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 E MICHIGAN AVE
LANSING MI
48912-1811
US

IV. Provider business mailing address

1701 LAKE LANSING RD SUITE 201
LANSING MI
48912-3798
US

V. Phone/Fax

Practice location:
  • Phone: 517-364-1000
  • Fax:
Mailing address:
  • Phone: 517-484-2777
  • Fax: 517-484-7377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: KENNETH SAMUEL RUDMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 517-484-2777