Lake County Internal Medicine, Inc.

NPI #1922799378 in Mentor, Ohio

Provider Information

NPI Number: 1922799378
Entity Type: Organization
Organization Name: Lake County Internal Medicine, Inc.
Primary Specialty: Internal Medicine
Enumeration Date: May 17, 2023
Last Updated: May 17, 2023

Practice Location

Address: 9485 MENTOR AVE STE 104
City: Mentor
State: Ohio
ZIP Code: 44060-8722
Phone: (440) 205-5770

Authorized Official

Name: DR. HAITHAM J KOUSA, MD
Title: OWNER
Phone: (440) 681-0300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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