Individual
DR. MARJORIE E LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3209 W SMITH VALLEY RD, STE. 251, GREENWOOD, IN 46142-8495
(317) 893-2364
(317) 851-8066
Mailing address
3209 W SMITH VALLEY RD, STE. 251, GREENWOOD, IN 46142-8495
(317) 893-2364
(317) 851-8066
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01024834A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100333590
—
IN
Enumeration date
02/20/2006
Last updated
08/12/2013
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