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

Michigan State University

Organization Family Medicine Physician · NPI 1851470744

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

In the registry since
2006
Specialties on file
11
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Practice location Address checks out

804 Service Rd Ste A217
East Lansing, MI 48824-7015
Phone: (517) 353-8122
Fax: (517) 432-3928
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Geriatric Medicine (Family Medicine) Physician Taxonomy 207QG0300X
Sports Medicine (Family Medicine) Physician Taxonomy 207QS0010X
Internal Medicine Physician Taxonomy 207R00000X
Gastroenterology Physician Taxonomy 207RG0100X
Infectious Disease Physician Taxonomy 207RI0200X
Pulmonary Disease Physician Taxonomy 207RP1001X
Public Health & General Preventive Medicine Physician Taxonomy 2083P0901X
Neurology Physician Taxonomy 2084N0400X
Neurology with Special Qualifications in Child Neurology Physician Taxonomy 2084N0402X
General Practice Physician Taxonomy 208D00000X

Record details

NPI number1851470744
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lisa Rucker — Enrollment & Patient Accts Manager · (517) 355-8462
NPI enumeratedNovember 3, 2006
Last updated in NPPESApril 5, 2018
Mailing address804 Service Rd # A109f, East Lansing, MI 48824-7015

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