LAKESIDE INTERNAL MEDICINE PC
Ambulatory Health at Harper Ave, Saint Clair Shores, MI

License number
Michigan 4301058249
Category
Ambulatory Health
Type
Primary Care
Owner
Name: PAUL ANTONY
Title: PRESIDENT
Phone: (586) 778-5287
Address
Address
21519 Harper Ave STE 109, Saint Clair Shores, MI 48080
National Provider ID: 1386840502
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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LAKESIDE INTERNAL MEDICINE, PC

Saint Clair Shores, MI

Industry:
Health/Allied Services
Registration:
Jun 20, 2007
Addresses:
21519 Harper STE 109, Saint Clair Shores, MI 48080 (Physical)
Michigan (Mailing)
21327 Harper Ave, Saint Clair Shores, MI 48080
State ID:
00766H
Business type:
Domestic Professional Service Corporation
President, Principal:
Paul Antony (President, Principal)

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