MEDICARE: JOI MICHELLE LENCZOWSKI MD

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	207N00000X	Dermatology Physician	0101237988	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P01541696	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	7307269	OTHER	AETNA
2	0786762	OTHER	CIGNA
3	537362	OTHER	ANTHEM

General Provider Information

NPI Number	:	1316949290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOI MICHELLE LENCZOWSKI MD

Provider Business Mailing Address
First Line	:	301 CONCOURSE BLVD STE 190
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23059-5759
Country	:	US
Telephone Number	:	804-549-4030
Fax Number	:	804-549-4032

Provider Business Practice Location Address
First Line	:	7016 LEE PARK RD
Second Line	:	SUITE 100
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23111-3682
Country	:	US
Telephone Number	:	804-730-2652
Fax Number	:	804-559-3067

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	12/12/2018

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Directions to “ JOI MICHELLE LENCZOWSKI MD” Practice Location

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