Individual
EDWARD C. LAKE JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
235 E CHICAGO ST, COLDWATER, MI 49036-1783
(517) 279-8465
(517) 279-8665
Mailing address
235 E CHICAGO ST, COLDWATER, MI 49036-1783
(517) 279-8465
(517) 279-8665
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301043994
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1562337
—
MI
Enumeration date
05/22/2006
Last updated
07/08/2007
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