LAKEVIEW DIAGNOSTIC SERVICES (NPI# 1922175082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922175082 |
| Entity Type | Organization |
| Organization Name | LAKEVIEW DIAGNOSTIC SERVICES |
| Practice Address |
27727 Joan St Saint Clair Shores MI 48081-1425 |
| Practice Telephone | 5862938700 |
| Practice Fax Number | 5862938701 |
| Mailing Telephone | 5862938700 |
| Mailing Fax Number | 5862938701 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | LILY MANTIS (PRESIDENT) |
| Authorized Official Telephone | 5862938700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
AE068600 | MI | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LAKEVIEW DIAGNOSTIC SERVICES | 21519 Harper Ave Ste 107, Saint Clair Shores, MI 48080-2220 |
| Street Address |
27727 JOAN ST |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48081-1425 |
| 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 |
| Find all providers in zip 48081 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871923904 | Tg D.o. | Psychiatry & Neurology | 19699 E 8 Mile Rd, Saint Clair Shores, MI 48080-1655 | 2013-11-27 |
| 1366476715 | James M Voci | Psychiatry & Neurology | 19699 E 8 Mile Rd, Saint Clair Shores, MI 48080-1655 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134738545 | Tank Consultation Pllc | Psychiatry & Neurology | 6095 Mcallister Ct Se, Grand Rapids, MI 49546-3836 | 2020-07-31 |
| 1417578535 | Angelique Maria Manasseh | Psychiatry & Neurology | 28521 Orchard Lake Rd Ste B, Farmington Hills, MI 48334-2934 | 2020-04-29 |
| 1306473418 | International Medical Clinic Pllc | Psychiatry & Neurology | 26100 American Dr Ste 200, Southfield, MI 48034-2367 | 2020-03-26 |
| 1720636657 | Muhammad Irshad Khan | Psychiatry & Neurology | 4201 Saint Antoine St Ste Uhc -8d, Detroit, MI 48201-2153 | 2019-09-04 |
| 1992261481 | Lucid Neurology PC | Psychiatry & Neurology | 26400 W 12 Mile Rd Ste 20, Southfield, MI 48034-1774 | 2019-02-20 |
| 1417427352 | Ascension St. Mary's Hospital | Psychiatry & Neurology | 4705 Towne Centre Rd Ste 302, Saginaw, MI 48604-2819 | 2018-12-04 |
| 1205326873 | Montana Neurology Pllc | Psychiatry & Neurology | 2040 Grand River Anx Ste 200, Brighton, MI 48114 | 2018-05-18 |
| 1508353145 | Kalyan Yarraguntla | Psychiatry & Neurology | 4201 Saint Antoine St # 8c, Detroit, MI 48201-2153 | 2018-04-19 |
| 1225525389 | Ahmad Ballout | Psychiatry & Neurology | 27358 Michele St, Dearborn Heights, MI 48127-1809 | 2018-04-15 |
| 1245734730 | E.i. Neurology Associates, Pllc | Psychiatry & Neurology | 15945 19 Mile Rd Ste 106, Clinton Township, MI 48038-1147 | 2018-03-20 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CLAIR SHORES |
| Zip Code | 48081 |
Please comment or provide details below to improve the information on LAKEVIEW DIAGNOSTIC SERVICES.
| 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.