Provider Demographics
NPI:1891747887
Name:CENTIS HEALTH PC
Entity Type:Organization
Organization Name:CENTIS HEALTH PC
Other - Org Name:LANSING NEUROSURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:H
Authorized Official - Last Name:BILL
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:517-827-1800
Mailing Address - Street 1:1575 RAMBLEWOOD DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-6384
Mailing Address - Country:US
Mailing Address - Phone:517-827-1800
Mailing Address - Fax:517-827-1642
Practice Address - Street 1:1575 RAMBLEWOOD DR
Practice Address - Street 2:SUITE 200
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-6384
Practice Address - Country:US
Practice Address - Phone:517-827-1800
Practice Address - Fax:517-827-1642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N15460Medicare PIN
6103350001Medicare NSC