Great Lakes Cardiovascular Thoracic Surgery, Plc

NPI #1487760427 in Portage, Michigan

Provider Information

NPI Number
1487760427
Entity Type
Organization
Organization Name
Great Lakes Cardiovascular Thoracic Surgery, Plc
Primary Specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery)
Enumeration Date
Aug 22, 2006
Last Updated
Nov 13, 2007

Practice Location

Address
7901 S 12TH ST
Address 2
SUITE 201
ZIP Code
49024-3831
Phone
(269) 372-8687

Authorized Official

Name
DR. GEORGE JOSEPH MACK, D.O.
Title
PRESIDENT
Phone
(269) 372-8687

Specialties & Taxonomy Codes

Specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery)

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