LAKESIDE CANCER SPECIALISTS PLLC NPI 1134254311

NPI Information

NPI: 1134254311
Provider Name: LAKESIDE CANCER SPECIALISTS, PLLC
Classification: Clinic/Center - 261QX0200X
Entity Type: Organization

Specialization: Oncology

Address:
3950 HOLLYWOOD RD
SUITE 240
SAINT JOSEPH, MI
ZIP 49085
Phone: (269) 428-4411
Get Directions

LAKESIDE CANCER SPECIALISTS, PLLC is an oncology clinic center in Saint Joseph, MI. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment and prescriptive services related to cancerous conditions. Services include chemotherapy infusions and monitoring of implanted chemotherapeutic agents. LAKESIDE CANCER SPECIALISTS, PLLC NPI is 1134254311. The provider is registered as an organization entity type.

The provider's business location address is:

3950 HOLLYWOOD RD
SUITE 240
SAINT JOSEPH, MI
ZIP 49085-151
Phone: (269) 428-4411
Fax: (269) 428-4422

The provider's authorized official is Edmund Brian Paloyan .
The authorized official title is Owner and has the following contact phone number (269) 428-4411.

The enumeration date for this NPI number is 2/21/2007 and was last updated on 7/20/2009.

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	261QX0200X	Clinic/Center	Oncology			Yes

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
1	0P42500	OTHER		MEDICARE ID

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »