Provider Demographics
NPI:1770977621
Name:LEHNERTZ, NICHOLAS (MD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:
Last Name:LEHNERTZ
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 1:615 NORTH WOLFE STREET
Mailing Address - Street 2:WB602
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205-2103
Mailing Address - Country:US
Mailing Address - Phone:410-955-3630
Mailing Address - Fax:
Practice Address - Street 1:WHITE EARTH INDIAN HEALTH CENTER
Practice Address - Street 2:40520 COUNTY HIGHWAY 34
Practice Address - City:OGEMA
Practice Address - State:MN
Practice Address - Zip Code:56569-9612
Practice Address - Country:US
Practice Address - Phone:218-983-6209
Practice Address - Fax:218-983-6217
Is Sole Proprietor?:No
Enumeration Date:2015-03-27
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD839782083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine