Individual
LOREN J HELMUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
207 N TOWNLINE RD STE 101, LAGRANGE, IN 46761-1325
(260) 463-2143
(260) 463-9334
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
17126
SC
208600000X
Surgery Physician
Primary
01066528A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000614454
ANTHEM
IN
05
—
200948410
—
IN
01
—
P00836703
R.R. MEDICARE
IN
Enumeration date
04/04/2006
Last updated
11/23/2022
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