Lakeshore Ear Nose and Throat Center PC

NPI #1194921692 in Saint Clair Shores, Michigan

Provider Information

NPI Number: 1194921692
Entity Type: Organization
Organization Name: Lakeshore Ear Nose and Throat Center PC
Primary Specialty: Allergy & Immunology
Enumeration Date: Jun 22, 2007
Last Updated: Oct 12, 2007

Practice Location

Address: 21000 E 12 MILE RD
Address 2: STE 111
City: Saint Clair Shores
State: Michigan
ZIP Code: 48081-1116
Phone: (586) 779-7610

Authorized Official

Name: DR. DANIEL DJ MEGLER, MD
Title: PRESIDENT -CHIEF EXECUTIVE OFFICER
Phone: (586) 779-7610

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X
Allergy & Immunology	207K00000X	Primary

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