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

Michigan State University

Organization Sports Medicine (Family Medicine) Physician · NPI 1699858431

Michigan State University is a Sports Medicine (Family Medicine) Physician in East Lansing, Michigan. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
3

Practice location Address checks out

4660 S Hagadorn Rd Ste 420
East Lansing, MI 48823-5353
Phone: (517) 884-6100
Fax: (517) 884-6233
Show map & directions

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

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X
Sports Medicine (Family Medicine) Physician Taxonomy 207QS0010X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1699858431
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lisa Rucker — Enrollment & Patient Accts Manager · (517) 884-2976
NPI enumeratedOctober 23, 2006
Last updated in NPPESApril 5, 2018
Mailing address804 Service Rd # A109f, East Lansing, MI 48824-7015

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