Lake Ent INC

NPI #1124235346 in Willoughby, Ohio

Provider Information

NPI Number: 1124235346
Entity Type: Organization
Organization Name: Lake Ent INC
Primary Specialty: Otolaryngology
Enumeration Date: May 17, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 36100 EUCLID AVE
Address 2: #350
City: Willoughby
State: Ohio
ZIP Code: 44094-4456
Phone: (440) 942-9308

Authorized Official

Name: KHALIL AZEM, MD
Title: PRESIDENT
Phone: (440) 942-9308

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Otolaryngology	207Y00000X	Primary

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