Individual
DR. NICHOLAS W LAZOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 MERCER AVE, DECATUR, IN 46733-2303
(260) 724-2145
Mailing address
16229 CANYON RUN, FORT WAYNE, IN 46845-9082
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01048939A
IN
207Q00000X
Family Medicine Physician
01048939A
IN
Other
Enumeration date
02/21/2007
Last updated
06/18/2010
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