Individual
MITCHELL A LAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE STREET, 1 MALONEY, PHILADELPHIA, PA 19104
(215) 662-2300
Mailing address
3400 SPRUCE STREET, 1 MALONEY, PHILADELPHIA, PA 19104
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD044027E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015065430002
—
PA
Enumeration date
07/11/2006
Last updated
02/28/2011
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