Organization
LAKE LAZER EYE CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHABBIR KHAMBATI M.D. (PRESIDENT)
(586) 792-3891
Entity
Organization
Contact information
Practice address
35776 HARPER AVE, CLINTON TWP, MI 48035-3212
(586) 792-3891
Mailing address
35776 HARPER AVE, CLINTON TWP, MI 48035-3212
(586) 792-3891
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0501160
BLUE CROSS BLUE SHIELD
MI
05
—
4606945
—
MI
Enumeration date
02/21/2007
Last updated
06/09/2008
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