Mark Adrian Lake, M.D.

NPI #1104848423 in Lafayette, Indiana

Provider Information

NPI Number: 1104848423
Entity Type: Individual
Name: Mark Adrian Lake, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dermatology
Credential: M.D.
Enumeration Date: Jul 24, 2006
Last Updated: Jul 23, 2019

Practice Location

Address: 15 EXECUTIVE DR
Address 2: SUITE 4
City: Lafayette
State: Indiana
ZIP Code: 47905-3833
Phone: (765) 838-3428

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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