Individual
DR. KEVIN M LORENZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., F.A.C.S.
Contact information
Practice address
620 N 9TH ST, BISMARCK, ND 58501-4112
(701) 255-4673
(701) 255-4934
Mailing address
620 N 9TH ST, BISMARCK, ND 58501-4112
(701) 255-4673
(701) 255-4934
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
7221
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13979
BLSH OF ND
ND
05
—
18532
—
ND
05
—
7779480
—
SD
01
—
877221
ND BLUE SHIELD VISION SER
ND
Enumeration date
10/12/2005
Last updated
01/04/2008
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