GREAT LAKES PRACTITIONERS LLC - NPI 1689166860 - Internal Medicine in Parma, OH

Q: What is Great Lakes Practitioners LLC's NPI number?

The NPI number for Great Lakes Practitioners LLC is 1689166860. It was assigned to this organization in the NPPES registry on June 4, 2018.

Q: What is Great Lakes Practitioners LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

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About Great Lakes Practitioners Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREAT LAKES PRACTITIONERS LLC (NPI 1689166860) is a healthcare organization registered as a geriatric medicine in Parma, Ohio and active in the NPI registry since June 2018. The organization lists Kourosh Saghafi, President, as its authorized official.

NPPES Registry Identity

NPI1689166860

Entity TypeOrganization

Primary Taxonomy207RG0300X

Legal Business NameGREAT LAKES PRACTITIONERS LLC

Location Address6681 RIDGE RD STE 300Parma, OH 44129-5705

Mailing Address6681 Ridge Rd Ste 300Parma, OH 44129-5705 · (440) 842-8675 · Fax (440) 842-1299

Phone(440) 842-8675

Organization SubpartNo

Authorized OfficialKourosh SaghafiPresident · (440) 842-8675

Enumeration DateJune 4, 2018

Last NPPES UpdateMarch 13, 2019

✔ NPI 1689166860 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RG0300X

License✔ Licensed in OH · 4184295

Definition

An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.

6681 RIDGE RD STE 300, Parma, OH 44129

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Other Identifiers 1

Other4184295Ohio Business License

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHANNON MARIE STOCKING NP-C

Nurse Practitioner