Organization
LAKESHORE SURGICAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL J DECOOK MD (PRESIDENT/PHYSICIAN)
(616) 394-0673
Entity
Organization
Contact information
Practice address
577 MICHIGAN AVE, SUITE 202, HOLLAND, MI 49423-4911
(616) 394-0673
(616) 394-9825
Mailing address
577 MICHIGAN AVE, SUITE 202, HOLLAND, MI 49423-4911
(616) 394-0673
(616) 394-9825
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
04/25/2006
Last updated
08/22/2020
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