Individual
LOREN J WANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
303 S MAIN ST, BLUFFTON, IN 46714-2503
(260) 919-3880
(260) 919-3882
Mailing address
303 S MAIN ST, BLUFFTON, IN 46714-2503
(260) 919-3880
(260) 919-3882
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01024010A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100257630A
—
IN
Enumeration date
06/11/2006
Last updated
08/19/2015
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