MID MICHIGAN SURGEONS PC (NPI# 1316015597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316015597 |
| Entity Type | Organization |
| Organization Name | MID MICHIGAN SURGEONS PC |
| Practice Address |
1675 Watertower Place Suite 100 East Lansing MI 48823 |
| Practice Telephone | 5173320200 |
| Practice Fax Number | 5173320963 |
| Mailing Telephone | 5173320200 |
| Mailing Fax Number | 5173320963 |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2008-06-19 |
| Authorized Official Name | DAVID E HAGAN (PRESIDENT OWNER) |
| Authorized Official Telephone | 5173320200 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS | OC310610 | 01 |
| MI | BCN | G04746 | 01 |
| Street Address |
1675 WATERTOWER PLACE SUITE 100 |
| City | EAST LANSING |
| State | MI |
| Zip Code | 48823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558352294 | Timothy Melvin Mckenna | Surgery | 1675 Watertower Place, Suite 100, East Lansing, MI 48823 | 2005-11-02 |
| 1730160904 | Jeffrey R Johnson | Surgery | 1675 Watertower Place, Suite 100, East Lansing, MI 48823 | 2005-11-07 |
| 1578554804 | David E Hagan | Surgery | 1675 Watertower Place, Ste 100, East Lansing, MI 48823 | 2005-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144848631 | Joseph Santangelo | Technician | 2775 E Lansing Dr, East Lansing, MI 48823 | 2020-07-10 |
| 1679197701 | Alexandra Megan Bauer | Technician | 3839 Hunsaker Street, 121, East Lansing, MI 48823 | 2020-06-04 |
| 1689297756 | Nathan Barnhurst | Neuromusculoskeletal Medicine & OMM | 4660 Hagadorn Rd #500, East Lansing, MI 48823 | 2020-05-25 |
| 1861036006 | Rachel Amber Kelly | Registered Nurse | 221 W Lake Rd, #300, East Lansing, MI 48823 | 2019-10-31 |
| 1982176442 | Thomas Patrick Lilley | Occupational Therapist | 2900 Hannah Blvd. - Suite B102, East Lansing, MI 48823 | 2018-12-21 |
| 1386114684 | Anne Colleen Jack | Social Worker | 3100 West Road, East Lansing, MI 48823 | 2018-11-29 |
| 1346721420 | Mary Ann Malosh | Health Educator | 6265 Fenwick Ct, East Lansing, MI 48823 | 2018-08-27 |
| 1639668734 | Jennifer Lynn Box | Occupational Therapist | 2900 Hannah Blvd Ste. B102, Outpatient Rehab, East Lansing, MI 48823 | 2018-05-03 |
| 1598267288 | Wise Willow Counseling & Consulting LLC | Social Worker | 2875 Northwind Dr Ste 215, East Lansing, MI 48823 | 2018-03-08 |
| 1184142010 | Carlrianna Taylor | Technician | 2775 E Lansing Rd, E Lansing, MI 48823 | 2017-08-30 |
| Find all providers in zip 48823 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922623081 | Joon B Kim | Surgery | 1200 Michigan Ave Ste 655, East Lansing, MI 48823-4099 | 2020-06-14 |
| 1063827566 | Michelle Shadi Abghari | Surgery | 3500 Beaumont Park Dr Apt 312, East Lansing, MI 48823-8039 | 2014-06-24 |
| 1679667091 | Bradford Kent Mitchell | Surgery | 4660 S. Hagadorn Road, Suite 600, East Lansing, MI 48823 | 2006-10-02 |
| 1952408932 | Abdalmajid Katranji | Surgery | 2111 Merritt Rd, Suite 101, East Lansing, MI 48823-6916 | 2006-09-20 |
| 1588766828 | Janet Rose Osuch | Surgery | 4600 S Hagadorn Rd # 600, East Lansing, MI 48823-5306 | 2006-09-05 |
| 1467421693 | Robert L Osmer | Surgery | 4660 South Hagadorn Road, Suite 600, East Lansing, MI 48823 | 2006-03-17 |
| 1871570564 | Stanley J Rosol | Surgery | 6269 Mereford Ct, East Lansing, MI 48823-9213 | 2005-12-23 |
| 1700867025 | Daniel Laurence Hunt | Surgery | 221 W Lake Lansing Rd, Ste 300, East Lansing, MI 48823-8661 | 2005-11-14 |
| 1558352294 | Timothy Melvin Mckenna | Surgery | 1675 Watertower Place, Suite 100, East Lansing, MI 48823 | 2005-11-02 |
| 1538168463 | Harvey Bumpers | Surgery | 4660 S Hagadorn Rd, #600, East Lansing, MI 48823-5376 | 2005-07-21 |
| Find all providers in EAST LANSING | ||||
| City | EAST LANSING |
| Zip Code | 48823 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.