Great Lakes Cardiovascular Thoracic Surgery, PLC
Great Lakes Cardiovascular Thoracic Surgery, PLC is a Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Portage, Michigan. Licensed in Michigan. Registered with an NPI since 2006.
- Licensed in
- MI
- In the registry since
- 2006
Practice location Address checks out
7901 S 12th St Ste 201Portage, MI 49024-3831
Phone: (269) 372-8687
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician (primary) | Taxonomy 208G00000X · Licence 5101009076 (MI) |
|---|
Record details
| NPI number | 1487760427 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | George Mack — President · (269) 372-8687 |
| Other names | Great Lakes Vein Center |
| NPI enumerated | August 22, 2006 |
| Last updated in NPPES | November 13, 2007 |
| Mailing address | 7901 S 12th St, Suite 201, Portage, MI 49024-3831 |
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