Provider Demographics
NPI:1912076944
Name:LORENZ, GIFFORD WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:GIFFORD
Middle Name:WILLIAM
Last Name:LORENZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 14417
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-1417
Mailing Address - Country:US
Mailing Address - Phone:912-629-0457
Mailing Address - Fax:912-629-0468
Practice Address - Street 1:5354 REYNOLDS ST
Practice Address - Street 2:SUITE 318
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6007
Practice Address - Country:US
Practice Address - Phone:912-352-4777
Practice Address - Fax:912-351-0630
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA030816207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000370697NMedicaid
GAD30093Medicare UPIN
GA202I290232Medicare PIN