Organization
PERSONAL PHYSICIAN CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDY LAZRIS MD (PRESIDENT)
(443) 386-3381
Entity
Organization
Contact information
Practice address
6334 CEDAR LN STE 103, COLUMBIA, MD 21044-3898
(410) 531-2355
Mailing address
6334 CEDAR LN STE 103, COLUMBIA, MD 21044-3898
(410) 531-2355
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
D47447
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008203100
—
MD
01
—
04-03155
EVERCARE
—
05
—
380651100
—
MD
01
—
DPC6AL
BCBS
—
01
—
KG01ER 53498303
CAREFIRST BCBS
—
Enumeration date
06/10/2009
Last updated
10/13/2009
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