Organization
GREAT LAKES GYNECOLOGY & AESTHETICS INC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID LUIS HAMACHER MD,FACOG (PHYSICIAN-SURGEON)
(906) 233-9500
Entity
Organization
Contact information
Practice address
126 S 25TH ST, SUITE B, ESCANABA, MI 49829-1364
(906) 233-9500
(906) 233-9925
Mailing address
126 SOUTH 25TH STREET, SUITE B, ESCANABA, MI 49829
(906) 233-9500
(906) 233-9925
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
207VG0400X
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4662541
—
MI
Enumeration date
01/31/2007
Last updated
09/28/2009
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