Great Lakes Home Doctors PC
Organization Active NPI General Practice Physician · Walled Lake, MI
NPI 1679705354 · NPPES record last updated Apr 15, 2011
Key facts
- NPI
- 1679705354
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- GREAT LAKES HOME DOCTORS PC
- Practice address
- 1160 Villa CT N
Walled Lake, MI 48390-3376 - Phone
- (313) 978-2343
- NPI assigned
- Aug 14, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. Aundrey Lutskovsky, D.O.
- Title
- Owner
- Phone
- (313) 978-2343
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | Yes |
Addresses
Primary practice location
1160 Villa CT N
Walled Lake, MI 48390-3376
Mailing address
1160 Villa CT N
Walled Lake, MI 48390-3376
Other names
- Patient Care Clinic
Other providers in Walled Lake, MI
- Christina Marie Giasone
- Elizabeth Gibson-Paruch
- Gold Coast Physio, LLC
- Marjorie Denise Goulet
- Ashley Gray
- Green Thumb Case Management
- Alexis Kianna Griffin
- Guided Hands Massage Therapy
- Lauren Haelterman
- Jamie L Hafke
All providers in Walled Lake, MI · General Practice Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.