Individual
DR. LORRAINE WEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01038518A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000112574
ANTHEM PIN #
IN
05
—
100127970
—
IN
01
—
200311740 E
MEDICAID GROUP #
IN
01
—
370018015
MEDICARE RAILROAD #
IN
01
—
4345468
AETNA PIN #
IN
Enumeration date
08/12/2005
Last updated
10/14/2010
Update your record
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