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Michigan State University

Diagnostic Radiology Physician in East Lansing, MI · enumerated 2006 · authorized official Lisa Rucker, Enrollment & Patient Accts Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1891747614

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Registry record

Entity type Organization (Type 2)
Legal business name Michigan State University
Practice address 804 Service Rd # D100, East Lansing, MI, 48824
Fax (517) 432-4394
Enumeration date May 17, 2006
Last updated in NPPES Apr 5, 2018

Taxonomy & classification

2085B0100X Body Imaging Physician Allopathic & Osteopathic Physicians Secondary
2085D0003X Diagnostic Neuroimaging (Radiology) Physician Allopathic & Osteopathic Physicians · License 4301023246 (MI) Secondary
2085N0700X Neuroradiology Physician Allopathic & Osteopathic Physicians Secondary
2085N0904X Nuclear Radiology Physician Allopathic & Osteopathic Physicians Secondary
2085R0202X Diagnostic Radiology Physician Allopathic & Osteopathic Physicians Primary
2085R0204X Vascular & Interventional Radiology Physician Allopathic & Osteopathic Physicians Secondary
2085R0204X Vascular & Interventional Radiology Physician Allopathic & Osteopathic Physicians · License 4301040697 (MI) Secondary

Authorized official

Name Lisa Rucker
Title Enrollment & Patient Accts Manager

Other identifiers

Identifier Type State Issuer
1891747614 Medicaid MI -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Michigan State University located?
The practice location on file with NPPES is in East Lansing, MI.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2018-04-05. Verify at npiregistry.cms.hhs.gov.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2018-04-05.