Provider Demographics
NPI:1588158869
Name:RALPH A. HARVEY MD, PLLC
Entity type:Organization
Organization Name:RALPH A. HARVEY MD, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:ADAMS
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-977-0957
Mailing Address - Street 1:1350 E LAKE LANSING RD STE C
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-7413
Mailing Address - Country:US
Mailing Address - Phone:517-977-0957
Mailing Address - Fax:517-977-1006
Practice Address - Street 1:1350 E LAKE LANSING RD STE C
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-7413
Practice Address - Country:US
Practice Address - Phone:517-977-0957
Practice Address - Fax:517-977-1006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301056256207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty