Organization
LAKE LAZER EYE CENTER
Active
Parent organization
LAKE LAZER EYE CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKE LAZER EYE CENTER
Authorized official
DR. SHABBIR KHAMBATI MD (PREIDENT)
(586) 792-3891
Entity
Organization
Contact information
Practice address
44000 W 12 MILE RD, SUITE 112, NOVI, MI 48377-2644
(586) 792-3891
Mailing address
44000 W 12 MILE RD, NOVI, MI 48377-2644
(586) 792-3891
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
SK070791
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0501160
BLUE CARE NETWORK
MI
01
—
140631
GREAT LAKES
MI
05
—
4606945
—
MI
01
—
H42351
HAP
MI
Enumeration date
10/16/2007
Last updated
05/06/2008
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