Individual
MR. JOHN M LAZARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
131 SUNSET CT, WEST COLUMBIA, SC 29169-2429
(803) 796-2222
(803) 796-7839
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16869
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110180893
RAIL ROAD MEDICARE
SC
05
—
168696
—
SC
01
—
53138
MEDCOST
SC
01
—
S309354
HEALTH SOURCE
SC
Enumeration date
05/01/2006
Last updated
11/09/2020
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