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General NPI Number Information
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NPI Number | 1093707275
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Entity Type | Individual
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Provider Name | RICHARD PETER LENZ MD
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Gender | Male
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 06/30/2010
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Provider Practice Location Address
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Address Line | 885 UNION ST STE 145
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City | BANGOR
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State | ME
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Zip | 04401-3083
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Country | US
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Telephone | 207-973-9595
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Fax | 207-973-7755
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Provider Business Mailing Address
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Address Line | 885 UNION ST STE 145
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City | BANGOR
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State | ME
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Zip | 04401-3083
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Country | US
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Telephone | 207-973-9595
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Fax | 207-973-7755
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number | 011662
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License Number State | ME
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