MEDICARE: ROBERT LORENZ

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	207VM0101X	Maternal & Fetal Medicine Physician	4301032751	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	160F376970	OTHER	MI	BCBSM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164482824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT LORENZ

Provider Business Mailing Address
First Line	:	3226 WELLINGTON CT
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48324-2162
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3226 WELLINGTON CT
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48324-2162
Country	:	US
Telephone Number	:	248-417-1946
Fax Number	:

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

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	10/18/2022

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