Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 40234 | SC |
NPI | 1366474447 |
---|---|
Provider Name | Adam M Lazzarini |
First Address | Charlotte, NC 28289-6239 |
Second Address | West Columbia, SC 29169-4800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 19/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I58235 | (02) | NY |