| Lakeside Medical Group, Pc | |
|
72 S Washington St Suite 202 Oxford MI 48371-4973 | |
| (248) 628-0220 | |
| (248) 628-0226 |
| Full Name | Lakeside Medical Group, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 72 S Washington St, Oxford, Michigan |
| Authorized Official Name and Position | Steven L Hartz (PRESIDENT) |
| Authorized Official Contact | 2486280220 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Medical Group, Pc 72 S Washington St Suite 202 Oxford MI 48371-4973 Ph: (248) 628-0220 | Lakeside Medical Group, Pc 72 S Washington St Suite 202 Oxford MI 48371-4973 Ph: (248) 628-0220 |
| NPI Number | 1386769180 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 06/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386769180 | NPI | - | NPPES |
| 0856300954 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
| 291878311 | Medicaid | MI | |
| 207Q00000X | Other | MI | TAXONOMY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | SH007361 (Michigan) | Primary |
Glennan Medical Group Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 72 S Washington St, Suite 204, Oxford, MI 48371 Phone: 248-628-2233 Fax: 248-628-2384 | |
Meadowbrook Family Medcenters Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 385 N Lapeer Rd, Oxford, MI 48371 Phone: 248-628-2597 Fax: 248-628-8802 |