Organization
LAZAR MEDICAL GROUP, PC
Active
Other names
Bella Glow Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JOHN LAZAR MD (CO-OWNER/PRESIDENT)
(570) 560-8704
Entity
Organization
Contact information
Practice address
400 MARKET ST STE 5, WILLIAMSPORT, PA 17701-6344
(570) 993-5507
Mailing address
1640 OAK RIDGE PL, WILLIAMSPORT, PA 17701-1724
(570) 560-8704
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
207Q00000X
Family Medicine Physician
—
—
208600000X
Surgery Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
06/11/2025
Last updated
06/11/2025
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