MARK ADRIAN LAKE

LAFAYETTE, IN
NPI1104848423
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207N00000X Dermatology
(Licence: IN  01055166)
Enumeration Date2006-07-24
Last Update Date2019-07-23
Business Address
MARK ADRIAN LAKE M.D.
15 EXECUTIVE DR SUITE 4
LAFAYETTE, IN 47905-3833
Phone number: 765-838-3428
Mailing Address
MARK ADRIAN LAKE M.D.
15 EXECUTIVE DR SUITE 4
LAFAYETTE, IN 47905-3833
Phone number: 765-838-3428
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