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Organization

LAKE HOSPITAL SYSTEM INC

Active
Other names
LHPG Endocrinology
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT A TRACZ (CHIEF FINANCIAL OFFICER)
(440) 354-1051
Entity
Organization

Contact information

Practice address
16030 E HIGH ST STE 101, MIDDLEFIELD, OH 44062-9474
(440) 632-0594
(440) 632-0596
Mailing address
PO BOX 781389, DETROIT, MI 48278-1389
(800) 354-1985
(440) 350-4938

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
207RB0002X
Obesity Medicine (Internal Medicine) Physician
207RC0000X
Cardiovascular Disease Physician
207RC0001X
Clinical Cardiac Electrophysiology Physician
207V00000X
Obstetrics & Gynecology Physician
207X00000X
Orthopaedic Surgery Physician
208000000X
Pediatrics Physician
208600000X
Surgery Physician
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2017301
OH
Enumeration date
06/29/2006
Last updated
02/02/2022
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