Provider Demographics
NPI:1073118550
Name:ADVANCED INTERNAL MEDICINE PLLC
Entity Type:Organization
Organization Name:ADVANCED INTERNAL MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALVARADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-575-9614
Mailing Address - Street 1:2720 PLEASANT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-2410
Mailing Address - Country:US
Mailing Address - Phone:517-575-9614
Mailing Address - Fax:877-370-2381
Practice Address - Street 1:2720 PLEASANT GROVE RD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-2410
Practice Address - Country:US
Practice Address - Phone:517-575-9614
Practice Address - Fax:877-370-2381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-02
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty