Healthcare Provider Details

I. General information

NPI: 1285771915
Provider Name (Legal Business Name): MCLAREN GREATER LANSING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 08/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W GREENLAWN AVE
LANSING MI
48910
US

IV. Provider business mailing address

401 W GREENLAWN AVE
LANSING MI
48910-2819
US

V. Phone/Fax

Practice location:
  • Phone: 517-334-2121
  • Fax:
Mailing address:
  • Phone: 517-975-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DALE ROBERT THOMPSON
Title or Position: CFO
Credential:
Phone: 517-975-7555