Organization
LAKES URGENT CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANFORD J VIEDER D.O. (MEDICAL DIRECTOR)
(248) 926-9111
Entity
Organization
Contact information
Practice address
2300 HAGGERTY RD, SUITE 1010, WEST BLOOMFIELD, MI 48323-2184
(248) 926-9111
(248) 926-9112
Mailing address
PO BOX 251956, WEST BLOOMFIELD, MI 48325-1956
(248) 926-9111
(248) 926-9112
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N92240
HEALTH ALLIANCE PLAN
—
01
—
139387
CARE CHOICES
—
01
—
700F327420
BCBS OF MICHIGAN
—
Enumeration date
08/11/2006
Last updated
09/26/2013
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