Healthcare Provider Details

I. General information

NPI: 1922121839
Provider Name (Legal Business Name): GRADUATE MEDICAL EDUCATION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 E. MICHIGAN AVE
LANSING MI
48912
US

IV. Provider business mailing address

3309 TRAPPERS COVE TRAIL APT # 2C
LANSING MI
48910-8385
US

V. Phone/Fax

Practice location:
  • Phone: 517-364-1000
  • Fax:
Mailing address:
  • Phone: 517-944-1246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateMI

VIII. Authorized Official

Name: DR. DAVORAN CHICK
Title or Position: PROGRAM DIRECTOR
Credential: M.D.
Phone: 517-355-4718