Provider Demographics
NPI:1326049032
Name:IP, JOHN H (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:IP
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Gender:M
Credentials:MD
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Mailing Address - Street 1:405 W GREENLAWN AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-2898
Mailing Address - Country:US
Mailing Address - Phone:517-483-7550
Mailing Address - Fax:517-483-7575
Practice Address - Street 1:1140 E MICHIGAN AVE STE 400
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1806
Practice Address - Country:US
Practice Address - Phone:517-364-9650
Practice Address - Fax:517-364-9605
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2023-11-21
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Provider Licenses
StateLicense IDTaxonomies
MI4301059263207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2827633Medicaid
MIOC36345014Medicare ID - Type Unspecified
MI2827633Medicaid