Basic Information
| Provider Information | |||||||||
| NPI: | 1144758236 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THURMAN | ||||||||
| FirstName: | CLEOPATRA | ||||||||
| MiddleName: | NSOFWA | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MWANSA | ||||||||
| OtherFirstName: | CLEOPATRA | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | SPARROW HOSPITAL | ||||||||
| Address2: | 1215 EAST MICHIGAN AVENUE | ||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5174329277 | ||||||||
| FaxNumber: | 5174329414 | ||||||||
| Practice Location | |||||||||
| Address1: | 1215 EAST MICHIGAN AVENUE | ||||||||
| Address2: | SPARROW HOSPITAL | ||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5174329277 | ||||||||
| FaxNumber: | 5174329414 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2017 | ||||||||
| LastUpdateDate: | 06/01/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 5101023123 | MI | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.