Organization
LAKEVIEW MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL B STOUT (EXECUTIVE DIRECTOR)
(757) 539-0251
Entity
Organization
Contact information
Practice address
2000 MEADE PARKWAY, SUFFOLK, VA 23434-4259
(757) 539-0251
Mailing address
2000 MEADE PARKWAY, SUFFOLK, VA 23434-4259
(757) 539-0251
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI0022
RAILROAD MEDICARE
VA
Enumeration date
05/01/2006
Last updated
12/14/2009
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