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General NPI Number Information
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NPI Number | 1487741161
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Entity Type | Organization
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Legal Business Name | EDMUND J MESSINA MD PC
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 07/01/2009
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Provider Practice Location Address
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Address Line | 1675 WATERTOWER PL SUITE 600
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City | EAST LANSING
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State | MI
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Zip | 48823-6399
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Country | US
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Telephone | 517-324-3445
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Fax | 517-324-4330
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Provider Business Mailing Address
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Address Line | 1675 WATERTOWER PL SUITE 600
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City | EAST LANSING
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State | MI
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Zip | 48823-6399
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Country | US
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Telephone | 517-324-3445
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Fax | 517-324-4330
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. JAYNE L. MESSINA
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Credential | R.N.
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Telephone | 517-324-3445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | EM043341
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License Number State | MI
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