LAKESHORE ALLERGY PC NPI 1639108863

NPI Information

  • NPI: 1639108863
  • Provider Name: LAKESHORE ALLERGY PC
  • Classification: Allergy & Immunology - 207KA0200X
  • Specialization: Allergy
  • Entity Type: Organization
  • Address: 3290 N WELLNESS
    BLDG D STE 180
    HOLLAND, MI
    ZIP 49424
  • Phone: (616) 738-4262

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NPI Details

LAKESHORE ALLERGY PC is an allergy allergy immunology in Holland, MI. The provider is a physician who specializes in the diagnosis, treatment, and management of allergies. Source: National Uniform Claim Committee LAKESHORE ALLERGY PC NPI is 1639108863. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3290 N WELLNESS
BLDG D STE 180
HOLLAND, MI
ZIP 49424
Phone: (616) 738-4262
Fax: (616) 738-4266

The provider's authorized official is Julie Ann Hutson .
The authorized official title is Owner Operator Physician and has the following contact phone number (616) 738-4262.

The enumeration date for this NPI number is 7/1/2006 and was last updated on 2/27/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207KA0200XAllergy & ImmunologyAllergy4301051148MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14604806MEDICAIDMICHIGAN
20030084OTHERBCBS
3P105210OTHERBLUECH
4ON10600MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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