IndividualActive
Micah Lissy, MD
NPI 1154627370 · Sports Medicine (Orthopaedic Surgery) Physician · East Lansing, MI
Provider details
- NPI number
- 1154627370
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Orthopaedic Surgery) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 261158 (NY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
4660 S Hagadorn Rd Ste 420
East Lansing, MI 48823-5353
Phone: (517) 884-6100
Fax: (517) 884-6233
Approximate (ZIP-level) locationGet directions
Mailing address
804 Service Rd Ste A109b
East Lansing, MI 48824-7015
Registry dates
- Enumerated
- 2011-02-04
- Last updated
- 2022-07-26
- Certified
- 2022-07-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.