| NPI | 1720189244 |
|---|---|
| Former Legal Business Name | LAKESIDE OB/GYN |
| Entity Type | Organization |
| Authorized Contact | PETER G LEVINSON Md Owner 814-873-3926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-08-22 |