Organization
LAKEVIEW MEDICAL CENTER, INC
Active
Other names
Lakeview Churchland Radiology
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL B STOUT (CEO)
(757) 539-0251
Entity
Organization
Contact information
Practice address
4868 BRIDGE RD, SUFFOLK, VA 23435-2048
(757) 483-7900
(757) 483-7164
Mailing address
2000 MEADE PKWY, SUFFOLK, VA 23434-4259
(757) 539-0251
(757) 934-9497
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
215137
VA
261QR0206X
Mammography Clinic/Center
215137
VA
Other
Enumeration date
10/12/2010
Last updated
10/21/2010
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