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General NPI Number Information
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NPI Number | 1427023944
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Entity Type | Individual
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Provider Name | ANDREW LAZRIS MD
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Gender | Male
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Dates
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Enumeration Date | 02/19/2006
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Last Update Date | 10/13/2009
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Provider Practice Location Address
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Address Line | 6334 CEDAR LN STE 103
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City | COLUMBIA
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State | MD
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Zip | 21044-3898
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Country | US
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Telephone | 410-531-2355
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Fax | 410-531-7041
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Provider Business Mailing Address
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Address Line | 6334 CEDAR LN STE 103
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City | COLUMBIA
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State | MD
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Zip | 21044-3898
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Country | US
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Telephone | 410-531-2355
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Fax | 410-531-7041
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D0047447
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License Number State | MD
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