Organization
LAKESHORE FAMILY CARE, PC
Active
Parent organization
LAKESHORE FAMILY CARE, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKESHORE FAMILY CARE, PC
Authorized official
DR. JOEL ELMER ANHALT D.O. (PHYSICIAN)
(231) 889-7030
Entity
Organization
Contact information
Practice address
3278 LAKE ST, ARCADIA, MI 49613-5121
(231) 889-7030
(231) 889-7032
Mailing address
72 FILER ST, MANISTEE, MI 49660-2717
(231) 723-5600
(231) 723-1048
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080E110050
BLUE CROSS BLUE SHIELD
MI
05
—
4612281
—
MI
Enumeration date
04/08/2011
Last updated
04/08/2011
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