LAKESHORE EAR NOSE AND THROAT CENTER PC


Address: 21000 E 12 Mile Rd, Suite 111, Saint Clair Shores, MI 48081-1116
Phone: 5867797610

LAKESHORE EAR NOSE AND THROAT CENTER PC (NPI# 1033202023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1033202023
Entity Type Organization
Organization Name LAKESHORE EAR NOSE AND THROAT CENTER PC
Practice Address 21000 E 12 Mile Rd
Suite 111
Saint Clair Shores
MI 48081-1116
Practice Telephone 5867797610
Mailing Telephone 5867797610
Enumeration Date 2006-10-02
Last Update Date 2007-10-12
Authorized Official Name DR. DANIEL DJ MEGLER (PRESIDENT CHIEF EXECUTIVE OFFICE)
Authorized Official Telephone 5867797610
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Y00000X Otolaryngology Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
BLUE SHIELD 0E01107 01
BLUE SHIELD GROUP 0E06192 01

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1285803346 Lakeshore Ear Nose and Throat Center PC Otolaryngology 11080 Hall Rd, A, Sterling Heights, MI 48314-1511 2008-02-22
1194921692 Lakeshore Ear Nose and Throat Center PC Internal Medicine 21000 E 12 Mile Rd, Ste 111, Saint Clair Shores, MI 48081-1116 2007-06-22

Office Location

Street Address 21000 E 12 MILE RD
SUITE 111
City SAINT CLAIR SHORES
State MI
Zip Code 48081-1116

Providers in the same location

NPI Name Taxonomy Address Enumeration
1255330486 Jennifer Kay Appleyard Allergy & Immunology 21000 E 12 Mile Rd, Ste 111, Saint Clair Shores, MI 48081-1116 2005-07-19
1881203479 Andrew Michael Keltz Speech-Language Pathologist 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 2020-07-29
1770120230 Holly Ann Reckers Speech-Language Pathologist 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 2019-12-04
1578037966 Maria Juliana Codino Speech-Language Pathologist 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 2019-01-18
1942779921 Maria D Samsa Physician Assistant 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 2018-11-19
1801331210 Katja N Tandarich Nurse Practitioner 21000 E 12 Mile Rd, Suite 111, Saint Clair Shores, MI 48081-1116 2016-12-21
1053854133 Jean P. Skeffington Speech-Language Pathologist 21000 E 12 Mile Rd, Suite111, Saint Clair Shores, MI 48081-1116 2016-11-22
1134588254 Alyssa Domenica Baker Physician Assistant 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 2016-02-17
1316350192 Seton Health Corporation of Southeastern Michigan Clinic/Center 21000 E 12 Mile Rd, Suite 105, Saint Clair Shores, MI 48081-1116 2014-06-09
1720404775 Sean Anthony Cassleman Internal Medicine 21000 E 12 Mile Rd, Saint Clair Shores, MI 48081-1116 2014-03-14
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1750865416 Saint Clair Family Pharmacy LLC Pharmacy 28001 Harper Ave., Saint Clair Shores, MI 48081 2018-09-19
1669995783 Terra Laquay Ginther Social Worker 28800 Harper Ave Ste A, Saint Clair Shores, MI 48081 2017-07-20
1245676998 Julia Hanson Social Worker 27941 Harper Ave., Suite 105, St. Clair Shores, MI 48081 2013-05-21
1760731301 Life Transition Service Community/Behavioral Health 21031 Sunnydale, St. Clair Shore, MI 48081 2012-08-29
1477868792 William Burr Wood Pharmacist 21000 Twelve Milerd., St Clair Shores, MI 48081 2010-08-11
1508094350 Dominic Anthony Garrisi Anesthesiology 21018 Bon Brae, St. Clair Shores, MI 48081 2009-06-30
1992947022 Karen Ostrowski-thomas Occupational Therapist 22442 Bayview, St. Clair Shores, MI 48081 2009-04-06
1891979787 Chirag Rachhadia Physical Therapist 29150 Harper Avenue, St. Clair Shores, MI 48081 2007-12-27
1598955114 Donna Warner Manczak Psychologist 21400 E Eleven Mil Rd, St Clair Shores, MI 48081 2007-07-30
1467652347 Sumit Narayanprasad Fogla Family Medicine 21400 E Eleven Mile Road, St. Clair Shores, MI 48081 2007-07-19
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Taxonomy Information

Taxonomy Code 207Y00000X
Grouping Allopathic & Osteopathic Physicians
Classification Otolaryngology

Taxonomy Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1669868402 Cameron M Heilbronn Otolaryngology 21000 E 12 Mile Rd Ste 111, Saint Clair Shores, MI 48081-1156 2015-04-08
1568554087 Adam D Rubin Otolaryngology 21000 E 12 Mile Rd, Suite 111, Saint Clair Shores, MI 48081-1116 2006-09-29
1881786341 Robert A Fishman Otolaryngology 21000 E 12 Mile Rd, Suite 111, Saint Clair Shores, MI 48081-1116 2006-09-29
1922190552 Daniel Dj Megler Otolaryngology 21000 E 12 Mile Rd, Suite 111, Saint Clair Shores, MI 48081-1116 2006-09-29

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1104445980 Anuja Dharap Otolaryngology 35630 Grand River Ave Apt 217, Farmington Hills, MI 48335-3120 2020-04-13
1598311334 Cogent Medical Group Pllc Otolaryngology 28300 Orchard Lake Rd Ste 101, Farmington Hills, MI 48334-3704 2019-08-16
1073025334 Robert J Stachler Md PC Otolaryngology 33200 W. 14 Mile Rd., Ste. 240, West Bloomfield, MI 48322 2017-10-26
1255878062 W.a. Foote Memorial Hospital, Inc Otolaryngology 205 N.east Ave, Jackson, MI 49201 2017-01-31
1174905822 Scott Jacob Schwartz Otolaryngology 6900 Orchard Lake Rd Ste 314, West Bloomfield, MI 48322-3457 2015-06-18
1104230523 Gary Zachary White Otolaryngology 300 North Ave Ste 1400, Battle Creek, MI 49017 2014-06-13
1437574530 Beacon Medical Group, Inc. Otolaryngology 711 S Health Pkwy Ste 1, Medical Office Building #1, Three Rivers, MI 49093-8354 2014-02-26
1124361621 Eric Fahed Succar Otolaryngology 44200 Woodward Ave Ste 201, Pontiac, MI 48341-5045 2013-04-03
1396086286 Nathan Vandjelovic Otolaryngology 4201 Saint Antoine St # 9c, Detroit, MI 48201-2153 2013-03-03
1497091078 Henry L Singer Otolaryngology 2341 Tor Ln, Petoskey, MI 49770-9768 2012-12-30
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Competitor

Search similar providers

City SAINT CLAIR SHORES
Zip Code 48081

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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