Provider Demographics
NPI:1316905748
Name:LORENZ, STEPHEN A III (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:A
Last Name:LORENZ
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 DELAFIELD RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215-3247
Mailing Address - Country:US
Mailing Address - Phone:412-782-5566
Mailing Address - Fax:412-782-2387
Practice Address - Street 1:100 DELAFIELD RD
Practice Address - Street 2:SUITE 207
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215-3247
Practice Address - Country:US
Practice Address - Phone:412-782-5566
Practice Address - Fax:412-782-2387
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD012174E207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6063981Medicaid
PA6063981Medicaid
PA709939Medicare ID - Type Unspecified