MEDICARE: DAVID M LENHOF PAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	50001093	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255383758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID M LENHOF PAC

Provider Business Mailing Address
First Line	:	115 LAKENGREN DR
Second Line	:
City	:	EATON
State	:	OH
Zip	:	45320-2778
Country	:	US
Telephone Number	:	937-336-5445
Fax Number	:

Provider Business Practice Location Address
First Line	:	8459 COLERAIN AVE UNIT C
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45239-3938
Country	:	US
Telephone Number	:	614-505-7633
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	04/30/2019

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Directions to “ DAVID M LENHOF PAC” Practice Location

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