Organization
LAKESIDE NEUROLOGY P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY MARTIN (PRACTICE MANAGER)
(586) 777-3375
Entity
Organization
Contact information
Practice address
28573 SCHOENHERR RD, WARREN, MI 48088-4330
(586) 777-3375
(586) 777-3380
Mailing address
28573 SCHOENHERR RD, WARREN, MI 48088-4330
(586) 777-3375
(586) 777-3380
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
04/02/2007
Last updated
03/28/2023
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