| Great Lakes Locums LLC | |
|
2950 Elmwood Ave Kenmore NY 14217-1304 | |
| (716) 447-6100 | |
| Not Available |
| Full Name | Great Lakes Locums LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 2950 Elmwood Ave, Kenmore, New York |
| Authorized Official Name and Position | Mian Majeed (OWNER) |
| Authorized Official Contact | 7168632454 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Locums LLC 13 Viscount Dr Williamsville NY 14221-1766 Ph: (716) 863-2454 | Great Lakes Locums LLC 2950 Elmwood Ave Kenmore NY 14217-1304 Ph: (716) 447-6100 |
| NPI Number | 1174058549 |
|---|---|
| Provider Enumeration Date | 04/24/2017 |
| Last Update Date | 04/24/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174058549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 208M00000X | Hospitalist | () | Secondary |
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