Provider Demographics
NPI:1962570580
Name:MICHAEL S. LASSER M.D. P.A.
Entity type:Organization
Organization Name:MICHAEL S. LASSER M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESSIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:LASSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-381-9008
Mailing Address - Street 1:6345 WOODSIDE CT
Mailing Address - Street 2:SUITE 102
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-3227
Mailing Address - Country:US
Mailing Address - Phone:410-381-9008
Mailing Address - Fax:410-381-9106
Practice Address - Street 1:6345 WOODSIDE CT
Practice Address - Street 2:SUITE 102
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-3227
Practice Address - Country:US
Practice Address - Phone:410-381-9008
Practice Address - Fax:410-381-9106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM27711174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD472M708FMedicare ID - Type Unspecified
MDE77265Medicare UPIN