Lake, Michael Thomas

Lake, Michael Thomas is an individual health care provider with primary practice located at 5950 Sw 81St St , Miami FL 33143-8120. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Lake, Michael Thomas can be contacted via phone (910) 257-4406.

Contact Information

Primary practice address
5950 Sw 81St St Miami FL 33143-8120
Phone: (910) 257-4406
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X K8647 Texas
Allopathic & Osteopathic Physicians / Surgery 208600000X 2006-00950 North Carolina

Profile Details

NPI number 1730179045
LBN Legal business name Lake, Michael Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2005
Last updated Apr 5th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730179045 NPPES
North Carolina Other 147WH BCBSNC
North Carolina MEDICAID N00952 BCBSNC
North Carolina MEDICAID 5909378 BCBSNC

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