# BRIAN LAVERENTZ

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1134864952
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 0102208192 | VA | Yes |
| 208D00000X | General Practice Physician | 0102208192 | VA | Yes |

## Other

- **Enumeration date:** 05/05/2022
- **Last updated:** 06/03/2026