Provider Demographics
NPI:1215227590
Name:LAZAR, JOZEF (MD)
Entity type:Individual
Prefix:DR
First Name:JOZEF
Middle Name:
Last Name:LAZAR
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 1:60 PLATO BLVD E
Mailing Address - Street 2:SUITE 270
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55107-1827
Mailing Address - Country:US
Mailing Address - Phone:651-209-1600
Mailing Address - Fax:
Practice Address - Street 1:1215 TOWN CENTRE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55123-1033
Practice Address - Country:US
Practice Address - Phone:651-251-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN59737207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNH400232285Medicare PIN