Lazarovich, Mark

Lazarovich, Mark is an individual health care provider with primary practice located at 53 Timber Ln , South Burlington VT 05403-5201. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Lazarovich, Mark can be contacted via phone (802) 864-0294.

Contact Information

Primary practice address
53 Timber Ln South Burlington VT 05403-5201
Phone: (802) 864-0294
Fax: (802) 864-3779
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X Vermont

Profile Details

NPI number 1083619431
LBN Legal business name Lazarovich, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2005
Last updated Jul 9th, 2007 - about 17 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 1083619431 NPPES
Vermont Other 18970 BLUE CROSS BLUE SHIELD VT
Vermont Other 92Q141 BLUE CROSS BLUE SHIELD VT
Vermont MEDICAID 0VN0712 BLUE CROSS BLUE SHIELD VT
Vermont Other 0176890-002 BLUE CROSS BLUE SHIELD VT
Vermont MEDICAID 02106825 BLUE CROSS BLUE SHIELD VT
Vermont Other 03V005 BLUE CROSS BLUE SHIELD VT

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