# LAKE HARBOR INTERNAL MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083800015
- **Authorized official:** DR. KERILYNN ERLAND M.D. (OWNER)
- **Authorized official phone:** (208) 853-4556

## Contact information

- **Practice address:** 3684 N HARBOR LN, BOISE, ID 83703-6914
- **Practice address phone:** (208) 853-4556
- **Practice address fax:** (208) 853-5544
- **Mailing address:** 3684 N HARBOR LN, BOISE, ID 83703-6914
- **Mailing address phone:** (208) 853-4556
- **Mailing address fax:** (208) 853-5544

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | Yes |
| 174400000X | Specialist | — | — | Yes |

## Other

- **Enumeration date:** 09/24/2007
- **Last updated:** 09/24/2007