Provider Demographics
NPI:1184182982
Name:MICHIGAN STATE UNIVERSITY
Entity type:Organization
Organization Name:MICHIGAN STATE UNIVERSITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/MICHIGAN STATE UNIVERSITY
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:W
Authorized Official - Last Name:DWYER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:517-355-0118
Mailing Address - Street 1:446 W. CIRCLE DRIVE, RM 409
Mailing Address - Street 2:JUSTIN S. MORRILL HALL OF AGRICULTURE
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824
Mailing Address - Country:US
Mailing Address - Phone:517-884-7277
Mailing Address - Fax:517-432-7644
Practice Address - Street 1:446 W. CIRCLE DRIVE, ROOM 409
Practice Address - Street 2:JUSTIN S. MORRILL HALL OF AGRICULTURE
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-1039
Practice Address - Country:US
Practice Address - Phone:517-884-7277
Practice Address - Fax:517-432-7644
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOARD OF TRUSTEES OF MICHIGAN STATE UNIIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-11
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)