# GEORGE J KELEN MD PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Lakeshore Cardiology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891956918
- **Authorized official:** DR. GEORGE JOHN KELEN MD, FACC (OWNER)
- **Authorized official phone:** (231) 845-7677

## Contact information

- **Practice address:** 913 E LUDINGTON AVE, LUDINGTON, MI 49431-2437
- **Practice address phone:** (231) 845-7677
- **Practice address fax:** (231) 843-0773
- **Mailing address:** 913 E LUDINGTON AVE, LUDINGTON, MI 49431-2437
- **Mailing address phone:** (231) 845-7677
- **Mailing address fax:** (231) 843-0773

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 4301079843 | MI | Yes |

## Other

- **Enumeration date:** 06/20/2008
- **Last updated:** 07/01/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4579580 | — | MI |
| 01 | — | DA9989 | RAILROAD MEDICARE | MI |