Lakeshore Medical Clinic, Ltd

NPI #1508061995 in Muskego, Wisconsin

Provider Information

NPI Number: 1508061995
Entity Type: Organization
Organization Name: Lakeshore Medical Clinic, Ltd
Primary Specialty: Durable Medical Equipment & Medical Supplies
Enumeration Date: Jun 18, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: S74W16775 JANESVILLE RD
City: Muskego
State: Wisconsin
ZIP Code: 53150-7742
Phone: (414) 281-1688

Authorized Official

Name: MASOOD WASIULLAH, MD
Title: PRESIDENT
Phone: (414) 744-6589

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies	332B00000X	Primary

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