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General NPI Number Information
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NPI Number | 1053554469
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Entity Type | Organization
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Legal Business Name | MICHIGAN SLEEP DIAGNOSTIC CENTER, LLC
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Dates
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Enumeration Date | 04/14/2009
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Last Update Date | 01/11/2010
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Provider Practice Location Address
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Address Line | 2000 SPRING ARBOR RD SUITE B
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City | JACKSON
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State | MI
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Zip | 49203-2887
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Country | US
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Telephone | 517-962-5220
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Fax | 517-962-5221
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Provider Business Mailing Address
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Address Line | 2000 SPRING ARBOR RD SUITE B
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City | JACKSON
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State | MI
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Zip | 49203-2887
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Country | US
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Telephone | 517-962-5220
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Fax | 517-962-5221
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Authorized Official
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Title or Position | PRESIDENT
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Name | RANGASWAMI PRAKASH
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Credential |
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Telephone | 517-917-7835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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