Organization
LAKESHORE MEDICAL CLINIC, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MASOOD WASIULLAH MD (PRESIDENT)
(414) 744-6589
Entity
Organization
Contact information
Practice address
180 N MILWAUKEE ST, MILWAUKEE, WI 53202-6013
(414) 227-1127
Mailing address
180 N MILWAUKEE ST, MILWAUKEE, WI 53202-6013
(414) 227-1127
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/18/2007
Last updated
08/22/2020
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