Provider Demographics
NPI:1427019793
Name:LINTZENICH, CATHERINE REES (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:REES
Last Name:LINTZENICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:JANE
Other - Last Name:REES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:856 J CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 KINGS WAY
Practice Address - Street 2:SUITE 2900
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-2505
Practice Address - Country:US
Practice Address - Phone:757-345-2600
Practice Address - Fax:757-253-1527
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200401114207Y00000X
VA0101255627207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I55314Medicare UPIN
NC5906637Medicaid
7903923OtherAETNA
199169OtherMEDCOST
2064912Medicare PIN
810505OtherPARTNERS
145JFOtherBCBS
SCQ01115Medicaid
WV3810009100Medicaid