Organization
LAKESHORE UROLOGY PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CALEB J FLEMING MD (MEDICAL DIRECTOR)
(616) 604-8363
Entity
Organization
Contact information
Practice address
1445 SHELDON RD, SUITE 102, GRAND HAVEN, MI 49417-2480
(616) 604-8363
(616) 604-8364
Mailing address
1445 SHELDON RD, SUITE 102, GRAND HAVEN, MI 49417-2480
(616) 604-8363
(616) 604-8364
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301048869
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101995044
—
MI
Enumeration date
02/06/2013
Last updated
02/15/2013
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