| Organization Name: | LAKESHORE VEIN &LASER CLINIC PLLC |
| NPI Number: | 1083753479 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANTHONY G FABAZ (OWNER) |
| Mailing Address: | 5 N Atkinson Dr Suite 304 Ludington |
| State: | MI US |
| Postal Code: | 494312918 |
| Phone Number: | 2318432600 |
| Fax Number: | 2318432665 |
| NPI Enumeration Date: | 02/05/2007 |
| NPI Last Update Date: | 06/18/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208G00000X |
| License Number: | 5101006766 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | 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. |