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Organization

LAKESHORE FAMILY CARE, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAUL JOSEPH ANTAL MD (PRESIDENT)
(231) 723-5600
Entity
Organization

Contact information

Practice address
72 FILER ST, MANISTEE, MI 49660-2717
(231) 723-5600
(231) 723-1048
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
05
3353612
MI
05
4612281
MI
Enumeration date
03/08/2007
Last updated
10/17/2007
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