Healthcare Provider Details

I. General information

NPI: 1770535163
Provider Name (Legal Business Name): BRIAN K LENTZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 02/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 JAHNKE RD SUITE 550
RICHMOND VA
23225-4017
US

IV. Provider business mailing address

7101 JAHNKE RD SUITE 550
RICHMOND VA
23225-4017
US

V. Phone/Fax

Practice location:
  • Phone: 804-560-8880
  • Fax: 804-560-9577
Mailing address:
  • Phone: 804-560-8880
  • Fax: 804-560-9577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101236572
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: