Graduated: 1993
NPI: 1588643035
Practice Locations (2)
LAKESHORE SURGERY ANESTHESIA BILLING
4190 24TH AVE
FORT GRATIOT, MI 480593882
8102164300
EASTSIDE GROUP LLC
28963 LITTLE MACK AVE, SUITE 103
SAINT CLAIR SHORES, MI 480813017
5864475110
Source: CMS National Downloadable File, September 2026.