Organization

Lakeshore Internal Medicine And Pediatric Associates

Multi-Specialty Clinic/Center in Holland, MI(View on Map)

Legal Business Name

Lakeshore Internal Medicine And Pediatric Associates

NPI Number

1003924739

NPI Type

Organization

Enumeration Date

08/25/2006

Specialties

(Taxonomies)

Code

261QM1300X

Primary Taxonomy

Yes

Licenses

State

Michigan
Michigan
Michigan

License Number

4301066494
4301074294
4301074445

Contact
Information

Purpose

Mailing
Location

Address

437 NORTH 120TH AVE
437 NORTH 120TH AVE

City

Holland
Holland

State

MI
MI

Postal Code

49424
49424

Country

US
US

Telephone Number

(616) 738-0737
(616) 738-0737

Authorized Official

Name

Barbara Martin

Title or Position

BILLING

Telephone Number

(616) 453-6329

Identifiers

Identifier

4193863
4531728
4529541

Identifier State

MI
MI
MI

Identifier Issuer

Unknown
Unknown
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 06/07/2016

Provider Address

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Organization

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