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General NPI Number Information
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NPI Number | 1699874701
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Entity Type | Organization
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Legal Business Name | MEDICAL AMBULATORY SERVICES FOR HEALTH PC
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 04/24/2008
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Provider Practice Location Address
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Address Line | 1107 E MILLER RD
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City | LANSING
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State | MI
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Zip | 48911-5312
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Country | US
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Telephone | 517-882-7566
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Fax | 517-882-5822
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Provider Business Mailing Address
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Address Line | PO BOX 27547
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City | LANSING
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State | MI
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Zip | 48909-0547
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Country | US
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Telephone | 517-882-3318
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Fax | 517-882-5822
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Authorized Official
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Title or Position | CEO
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Name | MR. EDWARD A. VARTANIAN
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Credential |
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Telephone | 517-882-3318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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