Provider Demographics
NPI:1629299722
Name:LAZAROFF, STEVEN H (CRNA)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:H
Last Name:LAZAROFF
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 MACARTHUR BLVD
Mailing Address - Street 2:ATTN ANESTHESIA
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2901
Mailing Address - Country:US
Mailing Address - Phone:219-836-7040
Mailing Address - Fax:219-513-1127
Practice Address - Street 1:901 MACARTHUR BLVD
Practice Address - Street 2:ATTN ANESTHESIA
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2901
Practice Address - Country:US
Practice Address - Phone:219-836-7040
Practice Address - Fax:219-513-1127
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28145373A367500000X
IN367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000518330OtherANTHEM BCBS
IN036088620Medicaid
IN200858420Medicaid
IL036088620Medicaid
IN200858420Medicaid
INCA9120WMedicare PIN