Healthcare Provider Details

I. General information

NPI: 1497736714
Provider Name (Legal Business Name): MARTIN P LEHENBAUER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 02/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7423 S MASON MONTGOMERY RD SUITE B
MASON OH
45040-7828
US

IV. Provider business mailing address

4700 SMITH RD SUITE A
CINCINNATI OH
45212-2787
US

V. Phone/Fax

Practice location:
  • Phone: 513-398-3445
  • Fax: 513-398-4680
Mailing address:
  • Phone: 513-533-1199
  • Fax: 513-533-6001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35050209
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: