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NPI Code Detail

MEDICARE: MR. MICHAEL DAVID GARRETT PA-C

MEDICARE: MR. MICHAEL DAVID GARRETT PA-C
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
1363A00000XPhysician Assistant5601004684MI

General Provider Information

NPI Number : 1487672770
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL DAVID GARRETT PA-C
Provider Business Mailing Address
First Line : 1625 RAMBLEWOOD DR STE 1
Second Line :
City : EAST LANSING
State : MI
Zip : 48823-6367
Country : US
Telephone Number : 517-324-3700
Fax Number : 517-203-3910
Provider Business Practice Location Address
First Line : 1625 RAMBLEWOOD DR STE 1
Second Line :
City : EAST LANSING
State : MI
Zip : 48823-6367
Country : US
Telephone Number : 517-324-3700
Fax Number : 517-203-3910
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 01/26/2026

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