LAKESHORE INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES – NPI #1003924739
Clinic/Center

LAKESHORE INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES is an AHC clinic located in HOLLAND, MI. NPPES has assigned the NPI number 1003924739 to LAKESHORE INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES on August 25, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QM1300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Multi-Specialty

The NPI profile was previously updated about 10 years ago on Jun 07, 2016. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LAKESHORE INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES below.

NPI Profile for
LAKESHORE INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES

NPI Number
1003924739
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LAKESHORE INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES
Primary location
437 NORTH 120TH AVE
HOLLAND, MI 49424
Phone: (616) 738-0737 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
BARBARA MARTIN
BILLING
Phone: (616) 453-6329
Updated
Identifiers

Identifiers for LAKESHORE INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDMI4529541
MEDICAIDMI4531728
MEDICAIDMI4193863
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM1300X
- Clinic/Center / Multi-Specialty (Primary)		 MI 4301074294

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.