# LAKESIDE URGENT CARE, P.C.

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

## Provider details

- **NPI number:** 1811226442
- **Authorized official:** MRS. TABATHA LEANNE STAGE (BILLING MANAGER)
- **Authorized official phone:** (248) 853-2009

## Contact information

- **Practice address:** 44472 HAYES RD, CLINTON TOWNSHIP, MI 48038-1090
- **Practice address phone:** (586) 412-0890
- **Practice address fax:** (586) 412-1069
- **Mailing address:** 44472 HAYES RD, CLINTON TOWNSHIP, MI 48038-1090
- **Mailing address phone:** (586) 412-0890
- **Mailing address fax:** (586) 412-1069

## Taxonomy

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

## Other

- **Enumeration date:** 12/10/2009
- **Last updated:** 12/10/2009