Individual
MATTHEW BOAZ LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL CENTER DR, DHMC DEPT. OF ANESTHESIOLOGY, LEBANON, NH 03756-1000
(603) 650-6177
Mailing address
1 MEDICAL CENTER DR, DHMC DEPT. OF ANESTHESIOLOGY, LEBANON, NH 03756-1000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101269652
VA
207L00000X
Anesthesiology Physician
18330
NH
Other
Enumeration date
04/21/2015
Last updated
12/30/2024
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