Provider Demographics
NPI:1487380655
Name:LAKESHORE HEALTH PLLC
Entity type:Organization
Organization Name:LAKESHORE HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SKIBITSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:208-906-2525
Mailing Address - Street 1:351 S JACOBSON RD
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-6551
Mailing Address - Country:US
Mailing Address - Phone:385-290-5363
Mailing Address - Fax:
Practice Address - Street 1:102 S EUCLID AVE STE 202
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-4939
Practice Address - Country:US
Practice Address - Phone:208-906-2525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty