Individual
DR. MARK LAZAROVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
53 TIMBER LN, SOUTH BURLINGTON, VT 05403-5201
(802) 864-0294
(802) 864-3779
Mailing address
53 TIMBER LN, SOUTH BURLINGTON, VT 05403-5201
(802) 864-0294
(802) 864-3779
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0176890-002
CIGNA
VT
05
—
02106825
—
NY
01
—
03V005
MVP
VT
05
—
0VN0712
—
VT
01
—
18970
BLUE CROSS BLUE SHIELD VT
VT
01
—
92Q141
BCBS NORTHEAST NEW YORK
NY
Enumeration date
06/14/2005
Last updated
07/09/2007
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