DR. JOHN LESTER GOUDREAU (NPI# 1477563096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477563096 |
| Entity Type | Individual |
| Full Name | DR. JOHN LESTER GOUDREAU |
| Credential | D.O. |
| Practice Address |
804 Service Rd # A217 East Lansing MI 48824-7015 |
| Mailing Address |
804 Service Rd # A201 East Lansing MI 48824-7015 |
| Practice Telephone | 5173538122 |
| Practice Fax Number | 5174323713 |
| Mailing Telephone | 5178842976 |
| Mailing Fax Number | 5174323928 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2016-08-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
5101012751 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1477563096 | 05 | |
| MI | 4318494 | 05 |
| Street Address |
804 SERVICE RD # A217 |
| City | EAST LANSING |
| State | MI |
| Zip Code | 48824-7015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710342027 | Kabelo Joseph Thusang | Psychiatry & Neurology | 804 Service Rd # A217, East Lansing, MI 48824-7015 | 2015-12-31 |
| 1184002966 | Lizl Maureen Lasky | Psychiatry & Neurology | 804 Service Rd # A217, East Lansing, MI 48824-7015 | 2015-05-12 |
| 1609213909 | Tariq Ahmad Gheith | Psychiatry & Neurology | 804 Service Rd # A217, East Lansing, MI 48824-7015 | 2013-05-28 |
| 1942523709 | Rachel Ann Rosenbaum | Psychiatry & Neurology | 804 Service Rd # A217, East Lansing, MI 48824-7015 | 2010-03-09 |
| 1700032570 | Lina Nagia | Ophthalmology | 804 Service Rd # A217, East Lansing, MI 48824-7015 | 2008-08-13 |
| 1972794774 | Christos Sidiropoulos | Psychiatry & Neurology | 804 Service Rd # A217, East Lansing, MI 48824-7015 | 2007-08-06 |
| 1700999166 | Jayne Heather Ward | Psychiatry & Neurology | 804 Service Rd # A217, East Lansing, MI 48824-7015 | 2006-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528680303 | Emilia Elizabeth Mattioli | Psychiatry & Neurology | 965 Fee Road Room A223, East Lansing, MI 48824 | 2020-05-14 |
| 1447871983 | James O'brien | Psychiatry & Neurology | Msu Psychiatry Residency Program, 965 Fee Road, Room A233, East Lansing, MI 48824 | 2020-05-06 |
| 1750916979 | Mulin Xiong | Student in an Organized Health Care Education/Training Program | 965 Wilson Road Suite A110, East Fee Hall, East Lansing, MI 48824 | 2020-03-09 |
| 1821659301 | Tovah Apolonia Aho | Psychiatry & Neurology | Michigan State University Psychiatric Residency, 965 Fee Road, Room A233, East Lansing, MI 48824 | 2019-06-25 |
| 1912564881 | Asmara Theresa Hoo | Psychiatry & Neurology | 965 Fee Road, Room A233, East Lansing, MI 48824 | 2019-05-24 |
| 1790276822 | Traverse Health Clinic and Coalition | Clinic/Center | East Fee Hall 965 Fee Road, Room A222, East Lansing, MI 48824 | 2018-05-24 |
| 1922598515 | Jubin Joseph Cheruvelil | Specialist/Technologist, Other | 446 W. Circle Dr. Room 249 Annex, Justin S. Morrill Hall of Agriculture, East Lansing, MI 48824 | 2018-05-18 |
| 1073003257 | Dawn Arvye Contreras | Health Educator | 446 West Circle Dr., Justin S. Morrill Hall of Agriculture, Room 166, East Lansing, MI 48824 | 2018-05-14 |
| 1710406046 | Kimberly Ann Breukink | Social Worker | 463 East Circle Drive, Michigan State University, Counseling and Psychiatric Services, East Lansing, MI 48824 | 2017-09-19 |
| 1043766314 | Ahmed Jouan | Psychiatry & Neurology | 804 Service Rd A217, East Lansing, MI 48824 | 2016-08-28 |
| Find all providers in zip 48824 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043766314 | Ahmed Jouan | Psychiatry & Neurology | 804 Service Rd A217, East Lansing, MI 48824 | 2016-08-28 |
| 1154545853 | Anmar Razak | Psychiatry & Neurology | 804 Service Rd Room A217, East Lansing, MI 48824-7040 | 2007-04-12 |
| 1316015068 | Ronald James Jakubiak | Psychiatry & Neurology | 6462 Timber View Dr, East Lansing, MI 48823-9321 | 2006-12-01 |
| 1629181128 | Arshad Majid | Psychiatry & Neurology | A217 Clinical Ctr, East Lansing, MI 48824-1313 | 2006-08-17 |
| 1356355762 | Edmund J Messina | Psychiatry & Neurology | 1675 Watertower Pl, Suite 600, East Lansing, MI 48823-8043 | 2006-07-28 |
| 1487643680 | Deborah F Gelinas | Psychiatry & Neurology | 804 Service Road, Room A117, East Lansing, MI 48823-7038 | 2005-10-19 |
| 1104828987 | Ahmad Nadim Al Sadat | Psychiatry & Neurology | 804 Service Rd Ste A217, East Lansing, MI 48824-7015 | 2005-08-11 |
| 1447639422 | Tori A Lafleur | Psychiatry & Neurology | 804 Service Rd Ste A217, East Lansing, MI 48824-7015 | 2015-05-24 |
| 1184002966 | Lizl Maureen Lasky | Psychiatry & Neurology | 804 Service Rd # A217, East Lansing, MI 48824-7015 | 2015-05-12 |
| 1104255611 | Barbara Pickut | Psychiatry & Neurology | 804 Service Rd Ste A217, East Lansing, MI 48824-7015 | 2013-11-05 |
| Find all providers in EAST LANSING | ||||
| City | EAST LANSING |
| Zip Code | 48824 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.