Provider Demographics
NPI:1720224645
Name:RED CEDAR VALLEY MEDICINE, PLLC
Entity Type:Organization
Organization Name:RED CEDAR VALLEY MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MILLER TOPA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-332-5342
Mailing Address - Street 1:6110 ABBOT RD
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1410
Mailing Address - Country:US
Mailing Address - Phone:517-332-5342
Mailing Address - Fax:517-332-3325
Practice Address - Street 1:6110 ABBOT RD
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-1410
Practice Address - Country:US
Practice Address - Phone:517-332-5342
Practice Address - Fax:517-333-3325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-23
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301065672208000000X
MI261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty