Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mark Adrian Lake, MD

Individual provider Dermatology Physician · NPI 1104848423

Mark Adrian Lake, MD is a Dermatology in Lafayette, Indiana. Graduated from Wright State University Boonshoft School of Medicine in 1996, 30 years ago. Accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
30
Trained at
Wright State University Boonshoft School of Medicine
Licensed in
IN
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

15 Executive Dr Ste 4
Lafayette, IN 47905-3833
Phone: (765) 838-3428
Fax: (765) 838-3440
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 01055166 (IN)

Record details

NPI number1104848423
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 24, 2006
Last updated in NPPESJuly 23, 2019
Mailing address15 Executive Dr, Suite 4, Lafayette, IN 47905-3833

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolWRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
Graduated 1996 (30 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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