NPI 1104848423

Mark Adrian Lake, MD

Practitioner Dermatology Physician Lafayette, IN

Practice location

Address: 15 Executive Dr Suite 4, Lafayette, IN 47905-3833
Phone: (765) 838-3428
Fax: (765) 838-3440

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence 01055166 (IN)

Other Dermatology providers in Indiana →

Registry record

NPI: 1104848423
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Jul 2006
Record last updated: 23 Jul 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.