Organization
LAKE CARDIOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AHMAD BANNA M.D. (PRESIDENT)
(440) 352-4956
Entity
Organization
Contact information
Practice address
124 LIBERTY ST, PAINESVILLE, OH 44077-3303
(440) 352-4956
(440) 352-0397
Mailing address
124 LIBERTY ST, PAINESVILLE, OH 44077-3303
(440) 352-4956
(440) 352-0397
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/02/2006
Last updated
12/10/2007
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