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Lakeside Internal Medicine PC

Primary Care Clinic/Center in Saint Clair Shores, MI · enumerated 2007 · authorized official Paul Antony, President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1386840502

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Registry record

Entity type Organization (Type 2)
Legal business name Lakeside Internal Medicine PC
Practice address 21519 Harper Ave Ste 109, Saint Clair Shores, MI, 48080
Phone (586) 945-5012
Enumeration date Jun 25, 2007
Last updated in NPPES Aug 18, 2014

Taxonomy & classification

261QP2300X Primary Care Clinic/Center Ambulatory Health Care Facilities · License 4301058249 (MI) Primary

Authorized official

Name Paul Antony
Title President
Phone (586) 778-5287

Other identifiers

Identifier Type State Issuer
5199450 Medicaid MI -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Lakeside Internal Medicine PC?
Lakeside Internal Medicine PC is registered in NPPES as a Primary Care Clinic/Center (its primary provider taxonomy).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2014-08-18.