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General NPI Number Information
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NPI Number | 1568768257
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Entity Type | Organization
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Legal Business Name | REDI CARE FAMILY PRACTICE PC
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Dates
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Enumeration Date | 01/28/2011
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Last Update Date | 04/10/2012
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Provider Practice Location Address
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Address Line | 6910 S CEDAR ST SUITE 4
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City | LANSING
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State | MI
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Zip | 48911-6912
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Country | US
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Telephone | 517-694-4131
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Fax | 517-694-4137
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Provider Business Mailing Address
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Address Line | 6910 S CEDAR ST SUITE 4
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City | LANSING
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State | MI
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Zip | 48911-6912
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Country | US
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Telephone | 517-694-4131
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Fax | 517-694-4137
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID M PETERS
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Credential | D.O.
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Telephone | 517-694-4134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5101013524
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License Number State | MI
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