Organization
GREAT LAKES ORTHOPAEDICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY E LAWLEY D.O. (PRESIDENT)
(734) 422-8400
Entity
Organization
Contact information
Practice address
6255 INKSTER RD STE 103, GARDEN CITY, MI 48135-2538
(734) 422-8400
(734) 422-8563
Mailing address
6255 INKSTER RD STE 103, GARDEN CITY, MI 48135-2538
(734) 422-8400
(734) 422-8563
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540H227020
BCBSM
MI
Enumeration date
01/30/2007
Last updated
03/20/2013
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