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LAKESIDE HEALTHCARE SPECIALISTS PLLC NPI 1467527648


NPI Information

NPI: 1467527648
Provider Name: LAKESIDE HEALTHCARE SPECIALISTS PLLC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
3950 HOLLYWOOD RD
SUITE 270
SAINT JOSEPH, MI
ZIP 49085
Phone: (269) 983-0500
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LAKESIDE HEALTHCARE SPECIALISTS PLLC is an internal medicine in Saint Joseph, MI. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. LAKESIDE HEALTHCARE SPECIALISTS PLLC NPI is 1467527648. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3950 HOLLYWOOD RD
SUITE 270
SAINT JOSEPH, MI
ZIP 49085-159
Phone: (269) 983-0500
Fax: (269) 429-2240

The provider's authorized official is Sharon Deskins .
The authorized official title is Physician Owner and has the following contact phone number (269) 983-0500.

The enumeration date for this NPI number is 11/22/2006 and was last updated on 2/3/2016.


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
1207R00000XInternal MedicineSD062237MICHIGANNo
2207R00000XInternal MedicineKA036485MICHIGANNo
3207R00000XInternal MedicineAP062392MICHIGANNo
4207R00000XInternal MedicineSW015533MICHIGANNo
5207RA0000XInternal MedicineAdolescent MedicineVS046079MICHIGANNo
6207RP1001XInternal MedicinePulmonary DiseaseSS036858MICHIGANNo
7207R00000XInternal MedicineDP065168MICHIGANNo
8207R00000XInternal MedicineMS007105MICHIGANYes

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
1CG8207OTHERMICHIGANRAIL ROAD MEDICARE
20A110280OTHERMICHIGANBCBS
30M94300MEDICARE PINMICHIGAN

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

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.