# GREAT LAKES GERIATRICS PLC

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

## Provider details

- **NPI number:** 1265797583
- **Authorized official:** SETH PARKER M D (PRESIDENT)
- **Authorized official phone:** (586) 731-8400

## Contact information

- **Practice address:** 50505 SCHOENHERR RD, SUITE 340, SHELBY TOWNSHIP, MI 48315-3140
- **Practice address phone:** (586) 731-8400
- **Practice address fax:** (586) 731-8406
- **Mailing address:** 50505 SCHOENHERR RD, SUITE 340, SHELBY TOWNSHIP, MI 48315-3140
- **Mailing address phone:** (586) 731-8400
- **Mailing address fax:** (586) 731-8406

## Taxonomy

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

## Other

- **Enumeration date:** 07/12/2012
- **Last updated:** 07/16/2012