Individual
MICHAEL B. LAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
475 IRVING AVE, SUITE 200, SYRACUSE, NY 13210-1756
(315) 464-4686
(315) 464-7106
Mailing address
475 IRVING AVE, SUITE 200, SYRACUSE, NY 13210-1756
(315) 464-4686
(315) 464-7106
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
176488
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01128427
—
NY
Enumeration date
08/03/2006
Last updated
08/21/2013
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