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General NPI Number Information
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NPI Number | 1285924506
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Entity Type | Organization
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Legal Business Name | LAKESHORE FAMILY CARE, PC
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Dates
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Enumeration Date | 04/08/2011
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Last Update Date | 04/08/2011
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Provider Practice Location Address
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Address Line | 3278 LAKE ST
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City | ARCADIA
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State | MI
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Zip | 49613-5121
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Country | US
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Telephone | 231-889-7030
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Fax | 231-889-7032
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Provider Business Mailing Address
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Address Line | 72 FILER ST
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City | MANISTEE
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State | MI
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Zip | 49660-2717
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Country | US
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Telephone | 231-723-5600
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Fax | 231-723-1048
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JOEL ELMER ANHALT
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Credential | D.O.
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Telephone | 231-889-7030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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