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
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