Provider Demographics
NPI:1154379527
Name:GARCIA, MANUEL E (MD)
Entity type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:E
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3496 E LAKE LANSING RD
Mailing Address - Street 2:STE. 160
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-2288
Mailing Address - Country:US
Mailing Address - Phone:517-336-1200
Mailing Address - Fax:517-336-1202
Practice Address - Street 1:3496 E LAKE LANSING RD
Practice Address - Street 2:STE. 160
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-2288
Practice Address - Country:US
Practice Address - Phone:517-336-1200
Practice Address - Fax:517-336-1202
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301071864207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4823787Medicaid
MI1598712390OtherGROUP NPI
MI4823811Medicaid
MI4823820Medicaid
MI4823849Medicaid
MI1103312302OtherBCBS
MI4823811Medicaid
H36030Medicare UPIN