Lazarev, Mark Gregory

Lazarev, Mark Gregory is an individual health care provider with primary practice located at 600 N Wolfe St 1830 Bldg, Rm 420, Baltimore MD 21287-0006. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Lazarev, Mark Gregory can be contacted via phone (410) 614-6708.

Contact Information

Primary practice address
600 N Wolfe St 1830 Bldg, Rm 420 Baltimore MD 21287-0006
Phone: (410) 614-6708
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X MT185907 Pennsylvania
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X D69337 Maryland

Profile Details

NPI number 1104094739
LBN Legal business name Lazarev, Mark Gregory
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2008
Last updated Feb 11th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104094739 NPPES
Maryland MEDICAID 418086100

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