Provider Demographics
NPI:1538355144
Name:LAKEVIEW HEALTH CENTER PC
Entity type:Organization
Organization Name:LAKEVIEW HEALTH CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MACIEJ
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLAREWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:MC
Authorized Official - Phone:989-352-6474
Mailing Address - Street 1:P.O. BOX 770
Mailing Address - Street 2:418 WASHINGTON ST.
Mailing Address - City:LAKEVIEW
Mailing Address - State:MI
Mailing Address - Zip Code:48850-0770
Mailing Address - Country:US
Mailing Address - Phone:989-352-6474
Mailing Address - Fax:989-352-8451
Practice Address - Street 1:418 WASHINGTON ST.
Practice Address - Street 2:
Practice Address - City:LAKEVIEW
Practice Address - State:MI
Practice Address - Zip Code:48850-0770
Practice Address - Country:US
Practice Address - Phone:989-352-6474
Practice Address - Fax:989-352-8451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty