Organization
LAKELAND MEDICAL PRACTICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WARREN WHITE (VICE PRESIDENT PHYSICIAN PRACTICES)
(269) 983-8127
Entity
Organization
Contact information
Practice address
2002 S 11TH ST, NILES, MI 49120-4074
(269) 687-0200
(269) 684-0199
Mailing address
6416 DEANS HILL RD, BERRIEN CENTER, MI 49102-9750
(269) 471-7741
(269) 471-1581
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548588031
—
MI
Enumeration date
05/10/2010
Last updated
04/11/2013
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