Organization
LEBANON WELLNESS
Active
Other names
LANCASTER WELLNESS, Modern Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
SHAVKAT RUZIEV MD (OWNER)
(717) 297-7900
Entity
Organization
Contact information
Practice address
974 ISABEL DR, LEBANON, PA 17042-7482
(717) 297-7900
(717) 276-7323
Mailing address
974 ISABEL DR, LEBANON, PA 17042-7482
(717) 297-7900
(717) 276-7323
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104547266-0001
—
PA
Enumeration date
08/03/2023
Last updated
01/23/2026
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