IndividualActive
Alexander Lake, DO
NPI 1255860789 · Pediatric Hematology & Oncology Physician · Grand Rapids, MI
Provider details
- NPI number
- 1255860789
- Entity type
- Individual
- Primary specialty
- Pediatric Hematology & Oncology PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- License
- 5101025698 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
35 Michigan St Ne Fl 2
Grand Rapids, MI 49503-2514
Phone: (616) 267-1925
Fax: (616) 267-1005
Approximate (ZIP-level) locationGet directions
Mailing address
100 Michigan St Ne # Mc845
Grand Rapids, MI 49503-2560
Registry dates
- Enumerated
- 2017-06-08
- Last updated
- 2025-05-08
- Certified
- 2025-05-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.