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Organization
LAKE HOSPITAL SYSTEM
Active
Organization
LAKE HOSPITAL SYSTEM
Active
Other names
Lake Health Physician Group Electrophysiology
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT TRACZ (CFO)
(440) 354-1642
Entity
Organization
Contact information
Practice address
36100 EUCLID AVE, SUITE 400, WILLOUGHBY, OH 44094-4456
(440) 602-6735
(440) 946-3221
Mailing address
PO BOX 714328, COLUMBUS, OH 43271-4328
(440) 602-6735
(440) 946-3221
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
—
NULL
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
—
—
Other
Enumeration date
09/23/2010
Last updated
09/23/2010
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