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Organization

LAKESHORE DIAGNOSTICS ULTRASOUND CO.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. WILLIAM E BERNER (PRESIDENT)
(989) 892-8444
Entity
Organization

Contact information

Practice address
1003 WOODSIDE AVE, ESSEXVILLE, MI 48732-1234
(989) 892-8444
(989) 892-7455
Mailing address
1003 WOODSIDE AVE, ESSEXVILLE, MI 48732-1234
(989) 892-8444
(989) 892-7455

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104997089
MI
05
113012847
MI
05
3012847
MI
01
310Z910630
BLUE CROSS UPIN
MI
05
4997089
MI
05
718550205
MO
Enumeration date
11/11/2005
Last updated
02/07/2013
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