Organization
LAZAR MEDICAL GROUP, PC
Active
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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