Individual
LORENE WALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4075 OLD WESTERN ROW RD, MASON, OH 45040-3104
(513) 536-4673
(513) 536-0609
Mailing address
4075 OLD WESTERN ROW RD, MASON, OH 45040-3104
(513) 536-4673
(513) 536-0609
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35064233
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000239696
ANTHEM
OH
01
—
260052360
RAILROAD MEDICARE
—
01
—
349328000
MAGELLAN
—
Enumeration date
08/04/2006
Last updated
09/08/2014
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