Healthcare Provider Details

I. General information

NPI: 1154854685
Provider Name (Legal Business Name): DIGESTIVE CARE OF LANSING PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 04/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 MALL CT # 145
LANSING MI
48912-5200
US

IV. Provider business mailing address

503 MALL CT # 145
LANSING MI
48912-5200
US

V. Phone/Fax

Practice location:
  • Phone: 517-599-9616
  • Fax:
Mailing address:
  • Phone: 517-599-9616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number4301102047
License Number StateMI

VIII. Authorized Official

Name: ANAS BITAR
Title or Position: OWNER / AUTHORIZED OFFICIAL
Credential: MD
Phone: 517-599-9616