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Individual

BRIAN LENZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1400 US HWY 61 SOUTH, CRYSTAL CITY, MO 63019
(636) 933-1111
(636) 933-1030
Mailing address
16207 BEAR BRANCH CT, CHESTERFIELD, MO 63005-7003
(636) 527-2283
(636) 527-2283

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2002008832
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
124884
BLUE CROSS
MO
05
1548203268
MO
05
205819527
MO
01
426403
HEALTHLINK
MO
01
947071631
MERCYHEALTH
MO
01
P00225149
RAILROAD MEDICARE
MO
Enumeration date
06/13/2006
Last updated
08/18/2009
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