Organization
LAKESHORE INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES
Active
Organization
LAKESHORE INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA MARTIN CPC (BILLING)
(616) 453-6329
Entity
Organization
Contact information
Practice address
437 NORTH 120TH AVE, HOLLAND, MI 49424
(616) 738-0737
Mailing address
437 NORTH 120TH AVE, HOLLAND, MI 49424
(616) 738-0737
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
4301066494
MI
261QM1300X
Multi-Specialty Clinic/Center
4301074294
MI
261QM1300X
Multi-Specialty Clinic/Center
4301074445
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4193863
—
MI
05
—
4529541
—
MI
05
—
4531728
—
MI
Enumeration date
08/25/2006
Last updated
06/07/2016
Update your record
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