MEDICARE: LAUREN PAIGE SIBECK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	4301508724	MI

General Provider Information

NPI Number	:	1265995013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN PAIGE SIBECK MD

Provider Business Mailing Address
First Line	:	12369 E MICHIGAN AVE
Second Line	:
City	:	GRASS LAKE
State	:	MI
Zip	:	49240-9213
Country	:	US
Telephone Number	:	517-205-2525
Fax Number	:	517-205-2538

Provider Business Practice Location Address
First Line	:	12369 E MICHIGAN AVE
Second Line	:
City	:	GRASS LAKE
State	:	MI
Zip	:	49240-9213
Country	:	US
Telephone Number	:	517-205-4800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2019
Last Update Date	:	10/03/2023

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