Individual
LOREN WEBER KOUSOUROU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1500 N RITTER AVE, INDIANAPOLIS, IN 46219-3027
(317) 355-9290
Mailing address
8424 NAAB RD STE 1L, INDIANAPOLIS, IN 46260-1954
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
02006866A
IN
207R00000X
Internal Medicine Physician
68590
CT
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
02006866A
IN
Other
Enumeration date
05/11/2018
Last updated
09/03/2025
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