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

Michigan State University

Organization Body Imaging Physician · NPI 1891747614

Michigan State University is a Body Imaging Physician in East Lansing, Michigan. Licensed in Michigan. Registered with an NPI since 2006.

Licensed in
MI
In the registry since
2006
Specialties on file
7

Practice location Address checks out

804 Service Rd # D100
East Lansing, MI 48824-7015
Phone: (517) 353-5053
Fax: (517) 432-4394
Show map & directions

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

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X
Body Imaging Physician Taxonomy 2085B0100X
Diagnostic Neuroimaging (Radiology) Physician Taxonomy 2085D0003X · Licence 4301023246 (MI)
Neuroradiology Physician Taxonomy 2085N0700X
Nuclear Radiology Physician Taxonomy 2085N0904X
Vascular & Interventional Radiology Physician Taxonomy 2085R0204X
Vascular & Interventional Radiology Physician Taxonomy 2085R0204X · Licence 4301040697 (MI)

Record details

NPI number1891747614
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lisa Rucker — Enrollment & Patient Accts Manager · (517) 884-2976
NPI enumeratedMay 17, 2006
Last updated in NPPESApril 5, 2018
Mailing address804 Service Rd Rm A109f, East Lansing, MI 48824-7015

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