Organization
LAKESHORE SURGERY ANESTHESIA BILLING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERIE WHITING (ADMINISTRATOR)
(810) 216-4401
Entity
Organization
Contact information
Practice address
4190 24TH AVE, FORT GRATIOT, MI 48059-3882
(810) 216-4300
Mailing address
4190 24TH AVE, FORT GRATIOT, MI 48059-3882
(810) 216-4300
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
05/14/2024
Last updated
05/14/2024
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