LAKEHSORE OTOLARYNGOLOGY NPI 1770696379

NPI Information

NPI: 1770696379
Provider Name: LAKEHSORE OTOLARYNGOLOGY
Classification: Otolaryngology - 207YS0123X
Entity Type: Organization

Specialization: Facial Plastic Surgery

Address:
577 MICHIGAN AVENUE
SUITE 101
HOLLAND, MI
ZIP 49423
Phone: (616) 393-2190
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LAKEHSORE OTOLARYNGOLOGY is a facial plastic surgery otolaryngology in Holland, MI. The provider is an otolaryngologist who specializes in facial plastic surgery. LAKEHSORE OTOLARYNGOLOGY NPI is 1770696379. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

577 MICHIGAN AVENUE
SUITE 101
HOLLAND, MI
ZIP 49423
Phone: (616) 393-2190
Fax: (616) 393-0147

The provider's authorized official is Theodore S Vanderveen .
The authorized official title is President and has the following contact phone number (616) 393-2190.

The enumeration date for this NPI number is 8/16/2006 and was last updated on 8/22/2020.

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
1	207YS0123X	Otolaryngology	Facial Plastic Surgery			Yes

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: 5/5/2024

NPI Synchronization or Removal

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