Organization
LAKE HOSPITAL SYSTEM
Active
Other names
Lake Health Physician Group Electrophysiology
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT TRACZ (CFO)
(440) 354-1642
Entity
Organization
Contact information
Practice address
36100 EUCLID AVE, SUITE 400, WILLOUGHBY, OH 44094-4456
(440) 602-6735
(440) 946-3221
Mailing address
PO BOX 714328, COLUMBUS, OH 43271-4328
(440) 602-6735
(440) 946-3221
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
—
—
Other
Enumeration date
09/23/2010
Last updated
09/23/2010
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