| NPI | 1477844686 |
|---|---|
| Doing Business As | LAKE HEALTH PHYSICIAN GROUP MENTOR GENERAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | RICHARD D. CICERO Sr. VP, Business Development 440-354-1739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2011-04-21 |