Lazaro, Larry Rivera

Lazaro, Larry Rivera is an individual health care provider with primary practice located at 1721 S Stephenson Ave , Iron Mountain MI 49801-3637. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Lazaro, Larry Rivera can be contacted via phone (810) 692-4030.

Contact Information

Primary practice address
1721 S Stephenson Ave Iron Mountain MI 49801-3637
Phone: (810) 692-4030
Fax: (616) 222-0284
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 4301069069 Michigan

Profile Details

NPI number 1568449007
LBN Legal business name Lazaro, Larry Rivera
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2005
Last updated May 30th, 2013 - about 11 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 1568449007 NPPES
Michigan MEDICAID 4786502
Michigan Other LL069069

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