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Individual

DR. MARK EDGAR LACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
111 COLCHESTER AVE, FLETCHER ALLEN HEALTH CARE, BURLINGTON, VT 05401-1473
(802) 847-5647
Mailing address
111 COLCHESTER AVE, FLETCHER ALLEN HEALTH CARE, BURLINGTON, VT 05401-1473
(802) 847-5647

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
042-0011386
VT
2085R0202X
Diagnostic Radiology Physician
19027
OK
2085R0202X
Diagnostic Radiology Physician
43235-020
WI
2085R0202X
Diagnostic Radiology Physician
K1519
TX
2085R0202X
Diagnostic Radiology Physician
M-8607
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
806357400
ID
Enumeration date
08/05/2006
Last updated
08/19/2008
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