Provider Demographics
NPI:1740258904
Name:LAZER, ZANE P (MD)
Entity type:Individual
Prefix:
First Name:ZANE
Middle Name:P
Last Name:LAZER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:418 GRAND PARK DR
Mailing Address - Street 2:SUITE 315
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26105-4000
Mailing Address - Country:US
Mailing Address - Phone:304-428-3500
Mailing Address - Fax:304-422-7900
Practice Address - Street 1:418 GRAND PARK DR
Practice Address - Street 2:SUITE 315
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26105-4000
Practice Address - Country:US
Practice Address - Phone:304-428-3500
Practice Address - Fax:304-422-7900
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2024-05-01
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Provider Licenses
StateLicense IDTaxonomies
OH35076219207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV10813000Medicaid
000747730OtherMOUNTAIN STATE BLUE CROSS
OH2172081Medicaid
5941763002OtherCIGNA
000747730OtherFREEDOM BLUE
5138752OtherAETNA
449568OtherHIGHMARK BLUE CROSS
31134604300OtherBRICKSTREET W/C
OH2172081Medicaid
WV0883362Medicare PIN
WV10813000Medicaid
000747730OtherFREEDOM BLUE