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Individual

MARK A LAZAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
720 FRY RD, STE. A, GREENWOOD, IN 46142-2410
(317) 881-0788
(317) 889-0775
Mailing address
6415 GREYRIDGE BLVD, INDIANAPOLIS, IN 46237-3145
(317) 788-7841

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0700059-1
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100137150A
IN
Enumeration date
07/19/2006
Last updated
07/22/2013
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