Provider Demographics
NPI:1285826404
Name:LAZAROV, LUDMIL (MD)
Entity Type:Individual
Prefix:DR
First Name:LUDMIL
Middle Name:
Last Name:LAZAROV
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 1:5926 N SANTA MONICA BLVD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-4618
Mailing Address - Country:US
Mailing Address - Phone:773-715-8034
Mailing Address - Fax:
Practice Address - Street 1:5926 N SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53217-4618
Practice Address - Country:US
Practice Address - Phone:773-715-8034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-11
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI51870-20207R00000X
COCDR.0001181208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine