LAKESHORE VEIN &LASER CLINIC PLLC
NPI 1083753479
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Ludington, MI

Active since February 05, 2007
5 N ATKINSON DR, SUITE 304, LUDINGTON, MI 49431(231) 843-2600(231) 843-2665 Get Directions Write a Review

NPPES record last updated: June 18, 2009. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Thoracic Surgery (Cardiothoracic Vascula...

About LAKESHORE VEIN &LASER CLINIC PLLC

This page provides the complete NPI Profile along with additional information for Lakeshore Vein &laser Clinic Pllc, a provider established in Ludington, Michigan operating as a Thoracic Surgery (cardiothoracic Vascular Surgery). The healthcare provider is registered in the NPI registry with number 1083753479 assigned on February 2007. The practitioner's primary taxonomy code is 208G00000X with license number 5101006766 (MI). The provider is registered as an organization and their NPI record was last updated 17 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Anthony G Fabaz Do (Owner)

NPI
1083753479 Verify this NPI
Provider Name
LAKESHORE VEIN &LASER CLINIC PLLC
Entity Type
Organization
Location Address
5 N ATKINSON DR SUITE 304 LUDINGTON, MI 49431
Location Phone
(231) 843-2600
Location Fax
(231) 843-2665
Mailing Address
5 N ATKINSON DR SUITE 304 LUDINGTON, MI 49431
Mailing Phone
(231) 843-2600
Mailing Fax
(231) 843-2665
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-05-2007
Last Update Date
06-18-2009
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Thoracic Surgery (Cardiothoracic Vascular Surgery)

Taxonomy Code
208G00000X
Type
Allopathic & Osteopathic Physicians
License No.
5101006766
License State
MI
Taxonomy Description
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. ANTHONY G FABAZ DO

Authorized Official Title
OWNER
Authorized Official Phone
(231) 843-2600

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
1816644MEDICAID (05)MI 
6164460001MEDICARE NSC (07)MI 
B46405MEDICARE UPIN (02) 

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Other Providers at the Same Location


The following 10 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
5 N ATKINSON DR, SUITE 201
LUDINGTON, MI 49431
Surgery
5 N ATKINSON DR, SUITE 201
LUDINGTON, MI 49431
Surgery (Vascular Surgery)
5 N ATKINSON DR, SUITE 304
LUDINGTON, MI 49431
Urology
5 N ATKINSON DR, SUITE 205
LUDINGTON, MI 49431
Specialist
5 N ATKINSON DR, SUITE 203
LUDINGTON, MI 49431
Orthopaedic Surgery
5 N ATKINSON DR, SUITE #200
LUDINGTON, MI 49431
Orthopaedic Surgery
5 N ATKINSON DR, SUITE 200
LUDINGTON, MI 49431
Internal Medicine
5 N ATKINSON DR, SUITE #207
LUDINGTON, MI 49431
Family Medicine
5 N ATKINSON DR
LUDINGTON, MI 49431
Internal Medicine (Cardiovascular Disease)
5 N ATKINSON DR
LUDINGTON, MI 49431

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1083753479, enumerated as an "organization" on February 05, 2007.

The provider is located at 5 N ATKINSON DR SUITE 304 LUDINGTON, MI 49431 and the phone number is (231) 843-2600.

Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.