Healthcare Provider Details

I. General information

NPI: 1255339115
Provider Name (Legal Business Name): EDWARD T HELBLE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 03/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3960 PATIENT CARE DR STE 109
LANSING MI
48911-4276
US

IV. Provider business mailing address

3955 PATIENT CARE DR STE A
LANSING MI
48911-4271
US

V. Phone/Fax

Practice location:
  • Phone: 517-853-5581
  • Fax: 517-272-0974
Mailing address:
  • Phone: 517-374-7600
  • Fax: 517-908-0886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number5101006610
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: