Organization
LAKESHORE MAMMOGRAPHY CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUDITH A SUTHERLAND (PRESIDENT)
(586) 228-8000
Entity
Organization
Contact information
Practice address
39200 GARFIELD RD, SUITE A, CLINTON TOWNSHIP, MI 48038-4095
(586) 228-8000
(586) 228-7870
Mailing address
39200 GARFIELD RD, SUITE A, CLINTON TOWNSHIP, MI 48038-4095
(586) 228-8000
(586) 228-7870
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104341680
—
MI
05
—
104361216
—
MI
01
—
700Q263820
BCBS & BCN
MI
Enumeration date
11/09/2006
Last updated
07/21/2022
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