Individual
DR. RANDALL G. LORENZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
623 SOUTH MAIN STREET, MOSCOW, ID 83843
(208) 882-2011
(208) 883-1853
Mailing address
623 SOUTH MAIN STREET, MOSCOW, ID 83843
(208) 882-2011
(208) 883-1853
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34153
AZ
207R00000X
Internal Medicine Physician
G31181
CA
207R00000X
Internal Medicine Physician
MD11024
OR
207R00000X
Internal Medicine Physician
ME83125
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
946345
—
AZ
Enumeration date
05/03/2006
Last updated
11/22/2011
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