Provider Demographics
NPI:1104857762
Name:DEERING, JAMES H (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:DEERING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1540 LAKE LANSING RD STE 107
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3757
Mailing Address - Country:US
Mailing Address - Phone:517-913-3800
Mailing Address - Fax:517-913-3801
Practice Address - Street 1:1540 LAKE LANSING RD STE 107
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3757
Practice Address - Country:US
Practice Address - Phone:517-913-3800
Practice Address - Fax:517-913-3801
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010075042085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1022963OtherMCLAREN HEALTH ADVANTAGE
MI1022963OtherMCLAREN HEALTH PLAN-COMMERCIAL
MI0M21440052OtherMEDICARE PLUS BLUE
MIP00312959OtherRAILROAD MEDICARE
MI1022963OtherMCLAREN HEALTH PLAN-MEDICAID
MI200000001194OtherPHP
MI4823885Medicaid
MI200000001194OtherPHP FAMILYCARE
MI3157311134OtherBCBS/BCN
MI4674535OtherAETNA
MI200000001194OtherPHP FAMILYCARE
MI1022963OtherMCLAREN HEALTH PLAN-MEDICAID