Provider Demographics
NPI:1275940223
Name:STENZEL, HARRY
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:
Last Name:STENZEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3202 E STONEWAY DR
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-6916
Mailing Address - Country:US
Mailing Address - Phone:419-625-4490
Mailing Address - Fax:
Practice Address - Street 1:3202 E STONEWAY DR
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-6916
Practice Address - Country:US
Practice Address - Phone:419-625-4490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-22
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-001504208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH34-001504OtherOHIO LICENSE 34-001504