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Individual

SHAUNA LORENZO-RIVERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
613 23RD ST STE 430, ASHLAND, KY 41101-2885
(606) 408-8200
(606) 408-6291
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 408-6200

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
57522
KY
208600000X
Surgery Physician
MD43226
TN
208C00000X
Colon & Rectal Surgery Physician
35.146884
OH
208C00000X
Colon & Rectal Surgery Physician
43226
TN
208C00000X
Colon & Rectal Surgery Physician
Primary
57522
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101313
AL
05
1507110
TN
05
259908999A
GA
01
4187700
BCBS
TN
01
5829223
CIGNA
01
P00643432
RR MEDICARE
Enumeration date
07/20/2006
Last updated
06/27/2023
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