LAKESIDE CANCER SPECIALISTS, PLLC (NPI# 1134254311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134254311 |
| Entity Type | Organization |
| Organization Name | LAKESIDE CANCER SPECIALISTS, PLLC |
| Practice Address |
3950 Hollywood Rd Suite 240 Saint Joseph MI 49085-9151 |
| Practice Telephone | 2694284411 |
| Practice Fax Number | 2694284422 |
| Mailing Telephone | 2694284411 |
| Mailing Fax Number | 2694284422 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2009-07-20 |
| Authorized Official Name | DR. EDMUND BRIAN PALOYAN (OWNER) |
| Authorized Official Telephone | 2694284411 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QX0200X |
Clinic/Center Specialization: Oncology |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE ID | 0P42500 | 01 |
| Street Address |
3950 HOLLYWOOD RD SUITE 240 |
| City | SAINT JOSEPH |
| State | MI |
| Zip Code | 49085-9151 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689678021 | Lowell D Smith | Internal Medicine | 3950 Hollywood Rd, Ste 240, Saint Joseph, MI 49085-9151 | 2005-06-13 |
| 1144799982 | Philip Jasheway | Physical Therapist | 3950 Hollywood Rd, Saint Joseph, MI 49085-9159 | 2018-11-23 |
| 1235608274 | Sharon Elizabeth Roberts | Occupational Therapist | 3950 Hollywood Rd, Saint Joseph, MI 49085-9159 | 2018-11-20 |
| 1588113666 | Jessica R Schulte | Nurse Practitioner | 3950 Hollywood Rd, Suite 100, Saint Joseph, MI 49085-9159 | 2016-09-29 |
| 1467804567 | Debora Tenter | Nurse Practitioner | 3950 Hollywood Rd, Suite 100, Saint Joseph, MI 49085-9159 | 2016-07-13 |
| 1649622796 | Emily Schlitz Fix | Specialist/Technologist | 3950 Hollywood Rd, Suite 140, Saint Joseph, MI 49085-9159 | 2016-07-12 |
| 1336599901 | Kaitlyn Jackson | Specialist/Technologist | 3950 Hollywood Rd, Suite 140, Saint Joseph, MI 49085-9159 | 2016-06-15 |
| 1558725903 | Adam Thiesse | Specialist/Technologist | 3950 Hollywood Rd, Suite 140, Saint Joseph, MI 49085-9159 | 2016-04-12 |
| 1336514587 | Laurel Joy Yoder | Advanced Practice Midwife | 3950 Hollywood Rd, Suite 100, Saint Joseph, MI 49085-9159 | 2015-12-14 |
| 1487021481 | Kathryn Jean Kern | Advanced Practice Midwife | 3950 Hollywood Rd, Suite 100, Saint Joseph, MI 49085-9159 | 2015-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134758949 | Ahmed Elshareif | Student in an Organized Health Care Education/Training Program | Lakeland Health, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2020-04-03 |
| 1033747225 | Ezra Fox | Student in an Organized Health Care Education/Training Program | Lakeland Health- Gme, 1234 Napier Avenue, St. Joseph, MI 49085 | 2020-04-01 |
| 1679033930 | Asad Butt | Student in an Organized Health Care Education/Training Program | Lakeland Health-gme, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2019-03-22 |
| 1184194714 | Benjamin Phillip Knuth | Physical Therapist | 3950 Hollywood Road, Suite 140, Saint Joseph, MI 49085 | 2018-11-27 |
| 1336624279 | Brandi Chatot | Counselor | 1101 Broad Street #8, Saint Joseph, MI 49085 | 2018-09-26 |
| 1396239562 | Lakeland Medical Practices | Family Medicine | 2500 Niles Ave., Suite 1, St. Joseph, MI 49085 | 2018-06-20 |
| 1760976518 | Premier Health Associates, Inc. | Home Health | 1111 Main Sr, St Joseph, MI 49085 | 2018-06-15 |
| 1053817783 | Chantell Strong | Student in an Organized Health Care Education/Training Program | Lakeland Health - Gme, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2018-04-02 |
| 1386144053 | Anjana Gupta, Dds, Pllc | Dentist | 2800 Niles Road, Saint Joseph, MI 49085 | 2018-02-19 |
| 1356858997 | Hope Reborn Counseling, Pllc | Counselor | 2816 Willa Dr, Saint Joseph, MI 49085 | 2018-01-04 |
| Find all providers in zip 49085 | ||||
| Taxonomy Code | 261QX0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oncology |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment and prescriptive services related to cancerous conditions. Services include chemotherapy infusions and monitoring of implanted chemotherapeutic agents. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225321045 | Lakeland Medical Practices | Clinic/Center | 3950 Hollywood Rd, Suite 240, Saint Joseph, MI 49085-9159 | 2011-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215119672 | Hope Cancer Clinic Pllc | Clinic/Center | 14555 Levan Rd Ste 110, Livonia, MI 48154-5083 | 2007-11-28 |
| 1366532590 | Dearborn Oncology Associates PC | Clinic/Center | 233 Chestnut Cir, Bloomfield Hills, MI 48304-2105 | 2006-10-16 |
| 1902329501 | Academic Hematology Oncology, PC | Clinic/Center | 23850 Van Born Rd, Dearborn Heights, MI 48125-2325 | 2017-07-25 |
| 1558741819 | Vicinitas Michigan, Inc. | Clinic/Center | 30600 Telegraph Rd, Suite 2345, Bingham Farms, MI 48025-4530 | 2015-06-02 |
| 1750650008 | Veterans Affairs Ann Arbor Healthcare System | Clinic/Center | 2215 Fuller Rd, Ann Arbor, MI 48105-2303 | 2011-12-15 |
| 1225306392 | St Mary Mercy Physician Practices | Clinic/Center | 14555 Levan Rd, Suite 112, Livonia, MI 48154-5083 | 2011-12-05 |
| 1295011138 | Henry Ford Medical Center Columbus | Clinic/Center | 39450 W 12 Mile Rd, Novi, MI 48377-3600 | 2011-10-24 |
| 1134459662 | Parvez Khan Md,pc | Clinic/Center | 861 Monroe St, Dearborn, MI 48124-2308 | 2010-01-06 |
| 1972734317 | Martin I. Schock, Md PC | Clinic/Center | 31700 Van Dyke Ave, Suite 110, Warren, MI 48093-7949 | 2009-08-03 |
| 1326239849 | Amnuay Singhakowinta Md PC | Clinic/Center | 785 N Lapeer Rd, Lake Orion, MI 48362-4012 | 2007-08-08 |
| Find all providers with the same taxonomy | ||||
| City | SAINT JOSEPH |
| Zip Code | 49085 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.