Lakeshore Medical Clinic Ltd
NPI #1174851893 in South Milwaukee, Wisconsin
Provider Information
- NPI Number
- 1174851893
- Entity Type
- Organization
- Organization Name
- Lakeshore Medical Clinic Ltd
- Primary Specialty
- Family Medicine
- Enumeration Date
- Nov 19, 2009
- Last Updated
- Apr 28, 2010
Practice Location
- Address
- 1100 MILWAUKEE AVE
- City
- South Milwaukee
- State
- Wisconsin
- ZIP Code
- 53172-2013
- Phone
- (414) 764-4003
Authorized Official
- Name
- MASOOD WASIULLAH, MD
- Title
- PRESIDENT
- Phone
- (414) 744-6589
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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