Provider Demographics
NPI:1255383469
Name:LENZ, WADE E (MD)
Entity type:Individual
Prefix:DR
First Name:WADE
Middle Name:E
Last Name:LENZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1949 GUNBARREL RD STE 206
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-7133
Mailing Address - Country:US
Mailing Address - Phone:423-495-4345
Mailing Address - Fax:423-495-4934
Practice Address - Street 1:5600 BRAINERD RD STE A4
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-5336
Practice Address - Country:US
Practice Address - Phone:423-266-4588
Practice Address - Fax:423-342-0103
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD55948207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
070114OtherHEALTH ALLIANCE
190471OtherIOWA HEALTH SOLUTIONS
IA0241745Medicaid
IA0194OtherJOHN DEERE HEALTH
235474OtherMIDLANDS CHOICE
IA42938OtherWELLMARK BC/BS
IA42938OtherWELLMARK BC/BS
H48429Medicare UPIN
IAI3952Medicare PIN
110228099Medicare PIN