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Individual

MR. ROBERT J LAZAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1115 S UNION ST, TRAVERSE CITY, MI 49684-3258
(231) 995-3657
(231) 995-3658
Mailing address
1115 S UNION ST, TRAVERSE CITY, MI 49684-3258
(231) 995-3657
(231) 995-3658

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
4301050475
MI
207KA0200X
Allergy Physician
4301050475
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0280257
BCBS OF MICHIGAN
MI
01
102519
PREFERED CHOICE
MI
01
110235925
RAILROAD MEDICARE
MI
05
2843379
MI
Enumeration date
03/30/2006
Last updated
04/20/2023
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