Provider Demographics
NPI:1588066054
Name:INGHAM NEPHROLOGY AND HYPERTENSION PC
Entity type:Organization
Organization Name:INGHAM NEPHROLOGY AND HYPERTENSION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEEDONA
Authorized Official - Middle Name:N
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-485-8217
Mailing Address - Street 1:405 W GREENLAWN
Mailing Address - Street 2:SUITE 230
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-0812
Mailing Address - Country:US
Mailing Address - Phone:517-485-8217
Mailing Address - Fax:517-489-4980
Practice Address - Street 1:405 W GREENLAWN
Practice Address - Street 2:SUITE 230
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-0812
Practice Address - Country:US
Practice Address - Phone:517-485-8217
Practice Address - Fax:517-489-4980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-16
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty