Organization
LAKESHORE MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MASOOD WASIULLAH MD (PRESIDENT)
(414) 744-6589
Entity
Organization
Contact information
Practice address
9200 W LOOMIS RD, STE 208, FRANKLIN, WI 53132-8887
(414) 427-3280
Mailing address
100 15TH AVENUE, SUITE 180, SOUTH MILWAUKEE, WI 53172
(414) 427-3280
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/18/2007
Last updated
06/29/2011
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