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General NPI Number Information
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NPI Number | 1376870162
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Entity Type | Organization
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Legal Business Name | LAKESHORE HEALTH PARTNERS - FAMILY MEDICINE
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Dates
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Enumeration Date | 11/16/2009
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Last Update Date | 11/16/2009
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Provider Practice Location Address
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Address Line | 8436 HOMESTEAD DR SUITE 220
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City | ZEELAND
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State | MI
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Zip | 49464-8390
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Country | US
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Telephone | 616-392-5141
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Fax |
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Provider Business Mailing Address
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Address Line | 602 MICHIGAN AVE
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City | HOLLAND
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State | MI
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Zip | 49423-4918
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Country | US
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Telephone | 616-392-5141
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Fax |
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Authorized Official
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Title or Position | VP FINANCE CFO
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Name | MR. TERRY L STEELE
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Credential |
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Telephone | 616-392-5141
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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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