Individual
DAVID E LENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7980 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4170
(260) 478-5160
(260) 432-6524
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02001826A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000001043
MPLAN
—
01
—
000000091887
BLUE CROSS BLUE SHIELD
—
01
—
080143877
RAILROAD MEDICARE
IN
01
—
10117
PHYSICIANS HEALTH PLAN
—
01
—
1100182712
ANTHEM PTAN
IN
05
—
200102480
—
IN
01
—
P02689456
RAILROAD PTAN
IN
01
—
Q00723960
RAILROAD PTAN
IN
Enumeration date
11/04/2005
Last updated
12/30/2024
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