MEDICARE: DR. JOHN MICHAEL LAZARUS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	32449	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528064011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN MICHAEL LAZARUS M.D.

Provider Business Mailing Address
First Line	:	60 OLD COLONY RD
Second Line	:
City	:	WELLESLEY HILLS
State	:	MA
Zip	:	02481-2844
Country	:	US
Telephone Number	:	781-237-2528
Fax Number	:

Provider Business Practice Location Address
First Line	:	95 HAYDEN AVE
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02421-7942
Country	:	US
Telephone Number	:	781-402-9000
Fax Number	:	781-402-9582

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	07/09/2007

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