Provider Demographics
NPI:1144089483
Name:LENZ, ALEXA RAE (MD)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:RAE
Last Name:LENZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALEXA
Other - Middle Name:RAE
Other - Last Name:LENZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:930 CHESTNUT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-2807
Mailing Address - Country:US
Mailing Address - Phone:304-598-6400
Mailing Address - Fax:
Practice Address - Street 1:930 CHESTNUT RIDGE RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-2807
Practice Address - Country:US
Practice Address - Phone:304-293-5323
Practice Address - Fax:304-293-8724
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program