# LAKESHORE FAMILY MEDICINE ASSOC PC

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

## Provider details

- **NPI number:** 1295832418
- **Authorized official:** CRAIG K MACLEAN DO (PRESIDENT)
- **Authorized official phone:** (716) 947-4851

## Contact information

- **Practice address:** 7060 ERIE RD, DERBY, NY 14047-9306
- **Practice address phone:** (716) 947-0408
- **Practice address fax:** (716) 947-0413
- **Mailing address:** 7060 ERIE RD, DERBY, NY 14047-9306
- **Mailing address phone:** (716) 947-0408
- **Mailing address fax:** (716) 947-0413

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 154802 | NY | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 07/30/2008