Organization
LAKELAND MEDICAL PRACTICES
Active
Other names
Lakeland Rheumatology
Organization subpart
No
Provider details
NPI number
Authorized official
WARREN WHITE JR. (VICE PRESIDENT PHYSICIAN PRACTICES)
(269) 983-8304
Entity
Organization
Contact information
Practice address
3950 HOLLYWOOD RD, 289, SAINT JOSEPH, MI 49085-9159
(269) 408-0990
(269) 408-0993
Mailing address
3950 HOLLYWOOD RD, 289, SAINT JOSEPH, MI 49085-9159
(269) 408-0990
(269) 408-0993
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
4301092597
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MI2051
MEDICARE GROUP #
MI
Enumeration date
06/08/2011
Last updated
03/14/2016
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