Lakeshore Family Care, Pc | |
72 Filer St Manistee MI 49660-2717 | |
(231) 723-5600 | |
(231) 723-1048 |
Full Name | Lakeshore Family Care, Pc |
---|---|
Speciality | Family Medicine |
Location | 72 Filer St, Manistee, Michigan |
Authorized Official Name and Position | Paul Joseph Antal (PRESIDENT) |
Authorized Official Contact | 2317235600 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Lakeshore Family Care, Pc 72 Filer St Manistee MI 49660-2717 Ph: (231) 723-5600 | Lakeshore Family Care, Pc 72 Filer St Manistee MI 49660-2717 Ph: (231) 723-5600 |
NPI Number | 1356472872 |
---|---|
Provider Enumeration Date | 03/08/2007 |
Last Update Date | 10/17/2007 |
Medicare PECOS PAC ID | 3274516877 |
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Medicare Enrollment ID | O20040612000159 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356472872 | NPI | - | NPPES |
3353612 | Medicaid | MI | |
4612281 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Paul J Antal |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1295845469 PECOS PAC ID: 3072596683 Enrollment ID: I20040612000191 |
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