Provider Demographics
NPI:1124036736
Name:LAZA, SORIN CRISTIAN (MD)
Entity type:Individual
Prefix:
First Name:SORIN
Middle Name:CRISTIAN
Last Name:LAZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 PETER JEFFERSON PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8835
Mailing Address - Country:US
Mailing Address - Phone:434-261-1261
Mailing Address - Fax:434-261-1262
Practice Address - Street 1:600 PETER JEFFERSON PKWY STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8835
Practice Address - Country:US
Practice Address - Phone:434-261-1261
Practice Address - Fax:434-261-1262
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101255644208M00000X, 207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP01347262Medicare PIN
VAQ46154AMedicare PIN
I64324Medicare UPIN
NC5905056Medicaid
NC2057459Medicare PIN
NCP00351569OtherRR MEDICARE