Edward C Lake Jr, MD | |
235 E Chicago St, Coldwater, MI 49036-1783 | |
(517) 279-8465 | |
(517) 279-8665 |
Full Name | Edward C Lake Jr |
---|---|
Gender | Male |
Speciality | Obstetrics & Gynecology |
Location | 235 E Chicago St, Coldwater, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1962456822 | NPI | - | NPPES |
1562337 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207V00000X | Obstetrics & Gynecology | 4301043994 (Michigan) | Primary |
Entity Name | Community Health Center Of Branch County |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1124055009 PECOS PAC ID: 9335037514 Enrollment ID: O20040309000671 |
Mailing Address | Practice Location Address |
---|---|
Edward C Lake Jr, MD 235 E Chicago St, Coldwater, MI 49036-1783 Ph: (517) 279-8465 | Edward C Lake Jr, MD 235 E Chicago St, Coldwater, MI 49036-1783 Ph: (517) 279-8465 |
Vangala A. Reddy, M.D. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 235 E Chicago St, Coldwater, MI 49036 Phone: 517-279-8465 Fax: 517-279-8665 | |
Dr. John Robert Clark, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 370 E Chicago St Ste 400, Coldwater, MI 49036 Phone: 517-279-8465 Fax: 517-279-8665 | |
Dr. Sabeena Pradhan, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 360 E Chicago St, Suite F, Coldwater, MI 49036 Phone: 517-278-6929 Fax: 517-278-1810 |