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Individual
LAMAR OCTAVIUS MACK
Active
Individual
LAMAR OCTAVIUS MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
A123815
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
TN
Other
Enumeration date
07/24/2008
Last updated
02/11/2021
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