Surgery
MICHIGAN STATE UNIVERSITY
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1699725895 · enumerated 2006-05-11 · record updated 2019-10-18. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: LISA RUCKER, Enrollment & Patient Accts Manager · (517) 355-8462
Addresses and phones
- Practice location 4660 S HAGADORN RD STE 600, EAST LANSING, MI, 48823-5383 (517) 267-2460 Fax (517) 884-8602 Google Maps Apple Maps OpenStreetMap
- Mailing address 804 SERVICE RD STE A109B, EAST LANSING, MI, 48824-7015 (517) 267-2460 Fax (517) 884-8602 Google Maps Apple Maps OpenStreetMap
Specialties
- Internal Medicine, Infectious Disease 207RI0200X
- Obstetrics & Gynecology 207V00000X
- Obstetrics & Gynecology, Reproductive Endocrinology 207VE0102X
- Otolaryngology 207Y00000X · License 4301097695 MI
- Surgery, Surgical Critical Care 2086S0102X
- Surgery, Trauma Surgery 2086S0127X
- Surgery, Surgical Oncology 2086X0206X · License 4301077538 MI
- Internal Medicine, Endocrinology, Diabetes & Metabolism 207RE0101X
- Internal Medicine, Hematology & Oncology 207RH0003X
- Surgery 208600000X · Primary
In this directory
Locations and evidence
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Practice location
EAST LANSING, MI, 488235383
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.