OrganizationActive
Eastern Michigan University
NPI 1346628534 · Health Maintenance Organization · Ypsilanti, MI
Provider details
- NPI number
- 1346628534
- Entity type
- Organization
- Primary specialty
- Health Maintenance OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Nikolis Gustafson, Athletic Trainer(612) 242-2676
- License
- 3667518 (MI)
Specialties & taxonomies
Managed Care Organizations
Practice location
799 N Hewitt Rd
Ypsilanti, MI 48197-1701
Phone: (734) 487-5179
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 446
Lester Prairie, MN 55354-0446
Registry dates
- Enumerated
- 2015-05-08
- Last updated
- 2015-05-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.