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Organization
GAHANNA MEDICAL PRACTICES INC
Active
Organization
GAHANNA MEDICAL PRACTICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN E LAKE DO (PHYSICIAN)
(614) 428-8200
Entity
Organization
Contact information
Practice address
4550 N HAMILTON RD, GAHANNA, OH 43230
(614) 428-8200
(614) 428-9700
Mailing address
4550 N HAMILTON RD, GAHANNA, OH 43230
(614) 428-8200
(614) 428-9700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34005856
OH
Other
Enumeration date
11/09/2006
Last updated
07/19/2012
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