Provider Demographics
NPI:1770591505
Name:GAVARIS, LAUREN Z (MD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:Z
Last Name:GAVARIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4910 MASSACHUSETTS AVE NW
Mailing Address - Street 2:SUITE #21
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-4300
Mailing Address - Country:US
Mailing Address - Phone:202-686-6700
Mailing Address - Fax:202-537-1442
Practice Address - Street 1:4910 MASSACHUSETTS AVE NW
Practice Address - Street 2:SUITE #21
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4300
Practice Address - Country:US
Practice Address - Phone:202-686-6700
Practice Address - Fax:202-537-1442
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2008-06-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0064114207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD411184200Medicaid
MDI70283Medicare UPIN
MDS572P588Medicare PIN