Organization
LAKESHORE RADIOLOGY ASSOCIATES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW J KOEBERL MD (VICE PRESIDENT)
(920) 320-3800
Entity
Organization
Contact information
Practice address
2300 WESTERN AVE, MANITOWOC, WI 54221-1450
(920) 320-3800
Mailing address
2300 WESTERN AVE, MANITOWOC, WI 54220-3712
(920) 320-3800
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32729200
—
WI
Enumeration date
07/13/2006
Last updated
03/22/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us