| Lakeshore Sleep Medicine Plc | |
|
14700 Lake Shore Dr Charlevoix MI 49720-1931 | |
| (231) 547-3124 | |
| Not Available |
| Full Name | Lakeshore Sleep Medicine Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 14700 Lake Shore Dr, Charlevoix, Michigan |
| Authorized Official Name and Position | Nathan Craig Boss (PHYSICIAN) |
| Authorized Official Contact | 2315473124 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeshore Sleep Medicine Plc 14700 Lake Shore Dr Charlevoix MI 49720-1931 Ph: (231) 547-3124 | Lakeshore Sleep Medicine Plc 14700 Lake Shore Dr Charlevoix MI 49720-1931 Ph: (231) 547-3124 |
| NPI Number | 1730292392 |
|---|---|
| Provider Enumeration Date | 08/17/2006 |
| Last Update Date | 12/05/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730292392 | NPI | - | NPPES |
| 900034219 | Other | MI | PRIORITY HEALTH |
| 080151722-1 | Other | MI | BCBS OF MI |
| 104941225 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301069390 (Michigan) | Primary |
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