Provider Demographics
NPI:1497736714
Name:LEHENBAUER, MARTIN P (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:P
Last Name:LEHENBAUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4700 SMITH RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2787
Mailing Address - Country:US
Mailing Address - Phone:513-533-1199
Mailing Address - Fax:513-533-6001
Practice Address - Street 1:7423 S MASON MONTGOMERY RD
Practice Address - Street 2:SUITE B
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-7828
Practice Address - Country:US
Practice Address - Phone:513-398-3445
Practice Address - Fax:513-398-4680
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35050209207Q00000X
OH35050209L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0562574Medicaid
08018735Medicare PIN
OH0562574Medicaid
OHLE0549805Medicare PIN
OHP00915563Medicare PIN