Provider Demographics
NPI:1093707275
Name:LENZ, RICHARD PETER (MD)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:PETER
Last Name:LENZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:885 UNION ST
Mailing Address - Street 2:STE 145
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3083
Mailing Address - Country:US
Mailing Address - Phone:207-973-9595
Mailing Address - Fax:207-973-7755
Practice Address - Street 1:885 UNION ST
Practice Address - Street 2:STE 145
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3083
Practice Address - Country:US
Practice Address - Phone:207-973-9595
Practice Address - Fax:207-973-7755
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2010-06-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME011662207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME303120099Medicaid
D03597Medicare UPIN
ME303120099Medicaid