Lakeshore Surgical Associates PC
Surgery in Holland, MI. Organization (NPI-2).
NPI number1013973585
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1013973585
- Entity type
- Organization (NPI-2)
- Legal business name
- Lakeshore Surgical Associates PC
- Organization subpart
- No
- Enumeration date
- Apr 25, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | – | – | Yes |
Practice location
577 Michigan AveSuite 202
Holland, MI 49423-4911
Phone 616-394-0673 · Fax 616-394-9825
Mailing address
577 Michigan AveSuite 202
Holland, MI 49423-4911
Phone 616-394-0673 · Fax 616-394-9825
Authorized official
Daniel J Decook
President/Physician
6163940673
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Other Surgery Physician providers in Holland, MI
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