| NPI | 1588941066 |
|---|---|
| Doing Business As | LAKESIDE UROLOGY |
| Entity Type | Organization |
| Authorized Contact | WARREN WHITE Vice President Physician Practices 269-983-8304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MI 4301063125) |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2016-03-14 |