Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Board of Trustees of Michigan State University

Organization Allergy & Immunology Physician · NPI 1821493974

Board of Trustees of Michigan State University is an Allergy & Immunology Physician in Lansing, Michigan. Licensed in Michigan. Registered with an NPI since 2014.

Licensed in
MI
In the registry since
2014
Specialties on file
4

Practice location Address checks out

1200 E Michigan Ave Ste 145
Lansing, MI 48912-1800
Phone: (517) 364-5440
Fax: (517) 364-5409
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Hematology & Oncology Physician (primary) Taxonomy 2080P0207X · Licence 4301045225 (MI)
Allergy & Immunology Physician Taxonomy 207K00000X · Licence 4301035591 (MI)
Hematology & Oncology Physician Taxonomy 207RH0003X · Licence 4301021298 (MI)
Pediatric Pulmonology Physician Taxonomy 2080P0214X · Licence 4301035591 (MI)

Record details

NPI number1821493974
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lisa Rucker — Enrollment & Patient Accts Super · (517) 355-8462
Other names Msu Cmds Clinic; Msu Cmds Clinic
NPI enumeratedOctober 31, 2014
Last updated in NPPESDecember 13, 2019
Certification dateDecember 13, 2019
Mailing address804 Service Rd Ste A109b, East Lansing, MI 48824-7015

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