Basic Information
| Provider Information | |||||||||
| NPI: | 1619058757 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LANSING RHEUMATOLOGY PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 259 | ||||||||
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| City: | EAST LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488260259 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5173391676 | ||||||||
| FaxNumber: | 5173392716 | ||||||||
| Practice Location | |||||||||
| Address1: | 6200 PINE HOLLOW DR | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | EAST LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488239700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5173391676 | ||||||||
| FaxNumber: | 5173392716 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2006 | ||||||||
| LastUpdateDate: | 09/21/2007 | ||||||||
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| AuthorizedOfficialLastName: | THAKUR | ||||||||
| AuthorizedOfficialFirstName: | NITI | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5173391676 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | 4301055581 | MI | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.