Provider Demographics
NPI:1962469189
Name:CARDIOLOGY GROUP OF LANSING P C
Entity Type:Organization
Organization Name:CARDIOLOGY GROUP OF LANSING P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARESH
Authorized Official - Middle Name:
Authorized Official - Last Name:JANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-482-2020
Mailing Address - Street 1:5894 MARENGO ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-8315
Mailing Address - Country:US
Mailing Address - Phone:517-745-3403
Mailing Address - Fax:517-482-3664
Practice Address - Street 1:2575 SPRING ARBOR RD STE 100
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-3652
Practice Address - Country:US
Practice Address - Phone:517-787-7844
Practice Address - Fax:517-783-5044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
060C310230OtherBCBS
060C310230OtherBCBS