Provider Demographics
NPI:1902910383
Name:LAZAR, HOWARD C (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:C
Last Name:LAZAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HOWARD
Other - Middle Name:C
Other - Last Name:PEREZ-LAZAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2637 N 29TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008
Mailing Address - Country:US
Mailing Address - Phone:602-799-8717
Mailing Address - Fax:480-981-0527
Practice Address - Street 1:2637 N 29TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008
Practice Address - Country:US
Practice Address - Phone:602-799-8717
Practice Address - Fax:480-981-0527
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28908207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ557548Medicaid
H34795Medicare UPIN
AZ557548Medicaid