# DR. SHAUN G LENCKI

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

## Provider details

- **NPI number:** 1639167562
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207VM0101X | Maternal & Fetal Medicine Physician | 2020007993 | MO | Yes |
| 207VM0101X | Maternal & Fetal Medicine Physician | ME86568 | FL | — |

## Other

- **Enumeration date:** 10/13/2005
- **Last updated:** 03/25/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 202013798 | TAX ID | FL |
| 05 | — | 265903400 | — | FL |
| 01 | — | 5361051 | AETNA | FL |
| 01 | — | 62954 | BC/BS | FL |
| 01 | — | N290176 | HEALTHEASE (MEDICIAD HMO) | FL |