Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lake Shore Pulmonology, PLC

Organization Critical Care Medicine (Internal Medicine) Physician · NPI 1245283696

Lake Shore Pulmonology, PLC is a Critical Care Medicine (Internal Medicine) Physician in Spring Lake, Michigan. Licensed in Michigan. Registered with an NPI since 2006.

Licensed in
MI
In the registry since
2006
Specialties on file
3

Practice location Address checks out

17357 Van Wagoner Rd Ste 2
Spring Lake, MI 49456-9702
Phone: (616) 847-1009
Fax: (616) 847-1607
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pulmonary Disease Physician (primary) Taxonomy 207RP1001X · Licence 4301407127 (MI)
Critical Care Medicine (Internal Medicine) Physician Taxonomy 207RC0200X · Licence 4301407127 (MI)
Sleep Medicine (Internal Medicine) Physician Taxonomy 207RS0012X · Licence 4301407127 (MI)

Record details

NPI number1245283696
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Ivey — Owner/Physician · (616) 847-1009
NPI enumeratedMay 18, 2006
Last updated in NPPESApril 8, 2010
Mailing address17357 Van Wagoner Rd, Suite 2, Spring Lake, MI 49456-9702

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