| Great Lakes Physician Practice Pc | |
|
113 Main St Silver Creek NY 14136-1452 | |
| (716) 934-3641 | |
| (716) 934-7443 |
| Full Name | Great Lakes Physician Practice Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 113 Main St, Silver Creek, New York |
| Authorized Official Name and Position | Mark T Ehalt (DIRECTOR) |
| Authorized Official Contact | 4126470943 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Physician Practice Pc 113 Main St Silver Creek NY 14136-1452 Ph: (716) 934-3641 | Great Lakes Physician Practice Pc 113 Main St Silver Creek NY 14136-1452 Ph: (716) 934-3641 |
| NPI Number | 1548668585 |
|---|---|
| Provider Enumeration Date | 12/08/2014 |
| Last Update Date | 12/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548668585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Barnes Primary Care Associates, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 113 Main St, Silver Creek, NY 14136 Phone: 716-934-4518 Fax: 716-934-7443 |