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Individual

IGOR LAZAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
303 PARKWAY DR NE, PMB 404, ATLANTA, GA 30312-1212
(404) 265-4520
(404) 265-3894
Mailing address
PO BOX 932925, ATLANTA, GA 31193-2925
(800) 364-9216
(423) 892-5838

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
049973
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000909378H
GA
05
000909378I
GA
01
005178
BCBSGA (NSC)
GA
01
1598710311
NPI
GA
01
1982637419
GROUP NPI
GA
01
329251
WELLCARE MEDICAID
GA
01
687151
BCBSGA (AMC)
GA
01
P00197617
RAILROAD MEDICARE
GA
Enumeration date
05/23/2006
Last updated
09/24/2008
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