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General NPI Number Information
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NPI Number | 1568567642
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Entity Type | Individual
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Provider Name | RICHARD EVERETT LORENZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3379 PEACHTREE RD NE SUITE 800
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City | ATLANTA
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State | GA
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Zip | 30326-1031
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Country | US
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Telephone | 404-266-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 1420 NORTHCLIFF TRCE
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City | ROSWELL
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State | GA
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Zip | 30076-3275
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Country | US
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Telephone | 404-374-5540
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Fax |
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 052779
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License Number State | GA
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