Provider Demographics
NPI:1588603450
Name:DUPLESSIS, ELAINE C (MD)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:C
Last Name:DUPLESSIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 LAKE LANSING RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3756
Mailing Address - Country:US
Mailing Address - Phone:517-913-3910
Mailing Address - Fax:517-913-3911
Practice Address - Street 1:1540 LAKE LANSING RD
Practice Address - Street 2:SUITE 205
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3756
Practice Address - Country:US
Practice Address - Phone:517-913-3910
Practice Address - Fax:517-913-3911
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301080517207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200827680Medicaid
INP00389018OtherRAILROAD INDIVIDUAL
INCK6957OtherRAILROAD GROUP
INP00389018OtherRAILROAD INDIVIDUAL
INCK6957OtherRAILROAD GROUP
INI65340Medicare UPIN
IN200827680Medicaid