Organization
LAKELAND FAMILY MEDICINE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS JOSEPH CHARETTE MD (PRESIDENT)
33030888999
Entity
Organization
Contact information
Practice address
155 MCDONALD DRIVE SW, NEW PHILADELPHIA, OH 44663
(330) 308-8999
(330) 308-8016
Mailing address
155 MCDONALD DRIVE SW, NEW PHILADELPHIA, OH 44663
(330) 308-8999
(330) 308-8016
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35079651C
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000286978
ANTHEM PIN
OH
01
—
004748044002
MEDICAL MUTUAL PROVIDER ID#
OH
05
—
2918383
—
OH
01
—
4578869
AETNA PIN
OH
01
—
P00047967
MEDICARE RAILROAD
OH
Enumeration date
09/05/2006
Last updated
08/11/2009
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