Provider Demographics
NPI:1447234026
Name:LANDAY, STUART P (MD)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:P
Last Name:LANDAY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1005 CHARLEVOIX DR STE 100
Mailing Address - Street 2:
Mailing Address - City:GRAND LEDGE
Mailing Address - State:MI
Mailing Address - Zip Code:48837-8186
Mailing Address - Country:US
Mailing Address - Phone:517-337-1668
Mailing Address - Fax:517-622-1205
Practice Address - Street 1:2001 COOLIDGE RD
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-1378
Practice Address - Country:US
Practice Address - Phone:517-337-1668
Practice Address - Fax:517-337-1779
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2022-09-20
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Provider Licenses
StateLicense IDTaxonomies
MI4301055431207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3117437Medicaid
MISL055431OtherSTATE LICENSE NUMBER
MI200000002264OtherPHPMM
MI180022278OtherRAILROAD MEDICARE
MIE21778Medicare UPIN
MI3117437Medicaid