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Individual

DR. MARK GREGORY LAZAREV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
600 N WOLFE ST, 1830 BLDG, RM 420, BALTIMORE, MD 21287-0006
(410) 614-6708
Mailing address
PO BOX 64264, BALTIMORE, MD 21264-4264

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
D69337
MD
207RG0100X
Gastroenterology Physician
MT185907
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
418086100
MD
Enumeration date
02/17/2008
Last updated
02/11/2013
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