MARK ADRIAN LAKE M.D.
Individual Provider (NPI-1)
Active
Dermatology
Provider Information
- NPI Number
1104848423- Provider Type
- Individual Provider (NPI-1)
- Credentials
- M.D.
- Status
- Active
Contact & Location
- Address
- 15 EXECUTIVE DR SUITE 4, LAFAYETTE, IN, 479053833
- Phone
- (765) 838-3428
- Fax
- (765) 838-3440
Specialties & Taxonomies
Dermatology
Primary License: IN #01055166