| Lakeland Physicians Group Pc | |
|
1265 W Huron St Waterford MI 48328-3677 | |
| (248) 683-1213 | |
| (248) 683-0387 |
| Full Name | Lakeland Physicians Group Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1265 W Huron St, Waterford, Michigan |
| Authorized Official Name and Position | Steven Zalla (OWNER) |
| Authorized Official Contact | 2486831213 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeland Physicians Group Pc 1265 W Huron St Waterford MI 48328-3677 Ph: (248) 683-1213 | Lakeland Physicians Group Pc 1265 W Huron St Waterford MI 48328-3677 Ph: (248) 683-1213 |
| NPI Number | 1194876136 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 04/28/2021 |
| Medicare PECOS PAC ID | 3274501747 |
|---|---|
| Medicare Enrollment ID | O20040922000553 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194876136 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Steven D Zalla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023096807 PECOS PAC ID: 9537137005 Enrollment ID: I20040923000093 |
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