Provider Demographics
NPI:1699924589
Name:LAZEROW, SUSAN KAUFMAN (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:KAUFMAN
Last Name:LAZEROW
Suffix:
Gender:F
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:DC VA MEDICAL CTR
Mailing Address - Street 2:50 IRVING STREET, NW
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20422-0001
Mailing Address - Country:US
Mailing Address - Phone:202-745-8151
Mailing Address - Fax:
Practice Address - Street 1:DC VA MEDICAL CTR
Practice Address - Street 2:50 IRVING STREET, NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20422-0001
Practice Address - Country:US
Practice Address - Phone:202-745-8151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD034210207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology