Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 01065593A | IN |
NPI | 1003912726 |
---|---|
Provider Name | Dr. Dean L Lenz |
First Address | Bloomington, IN 47402-1329 |
Second Address | Bloomington, IN 47403-5167 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 17/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200908840 | (05) | IN |
I32732 | (02) | IN |