# GREAT LAKES LOCUMS LLC

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

## Provider details

- **NPI number:** 1174058549
- **Authorized official:** MIAN MAJEED M.D. (OWNER)
- **Authorized official phone:** (716) 863-2454

## Contact information

- **Practice address:** 2950 ELMWOOD AVE, KENMORE, NY 14217-1304
- **Practice address phone:** (716) 447-6100
- **Mailing address:** 13 VISCOUNT DR, WILLIAMSVILLE, NY 14221-1766
- **Mailing address phone:** (716) 863-2454

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 208M00000X | Hospitalist Physician | — | NULL | — |
| 208M00000X | Hospitalist Physician | — | — | — |

## Other

- **Enumeration date:** 04/24/2017
- **Last updated:** 04/24/2017