Provider Demographics
NPI:1760454326
Name:LENZ, WILLIAM H (DPM)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:LENZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:H
Other - Last Name:LENZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM, PC
Mailing Address - Street 1:495 WATERFRONT DR E
Mailing Address - Street 2:SUITE 230
Mailing Address - City:HOMESTEAD
Mailing Address - State:PA
Mailing Address - Zip Code:15120-1140
Mailing Address - Country:US
Mailing Address - Phone:412-461-1108
Mailing Address - Fax:412-461-5490
Practice Address - Street 1:495 WATERFRONT DR E
Practice Address - Street 2:SUITE 230
Practice Address - City:HOMESTEAD
Practice Address - State:PA
Practice Address - Zip Code:15120-1140
Practice Address - Country:US
Practice Address - Phone:412-461-1108
Practice Address - Fax:412-461-5490
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002231L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008712020002Medicaid
PA1156610001OtherDMERC PROVIDER NUMBER
PA0004134492OtherAETNA PIN
PA401477XXWOtherMC GROUP PROVIDER NUMBER
PA17109911912OtherGROUP NPI
PA1205011277OtherDMERC NPI NUMBER
PA1007367OtherGATEWAY HMO INDIV PROV NU
PA401477OtherHIGHMARK INDIVIDUAL PROV#
PA455619OtherHIGHMARK GROUP NUMBER
PA0008712020002Medicaid
PA0004134492OtherAETNA PIN
PA401477OtherHIGHMARK INDIVIDUAL PROV#