Healthcare Provider Details

I. General information

NPI: 1578967634
Provider Name (Legal Business Name): CAPITOL AREA PULMONARY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2014
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
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

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

V. Phone/Fax

Practice location:
  • Phone: 517-574-5645
  • Fax:
Mailing address:
  • Phone: 517-574-5645
  • Fax: 517-574-5688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number05741L
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: FALAK SHANTA
Title or Position: CREDENTIALING
Credential:
Phone: 517-574-5645