Individual
MARIA CONSUELO LOZANO CELIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
36 E FRONT STREET, MEDIA, PA 19063
(302) 268-7477
(859) 203-3079
Mailing address
P.O. BOX 1606, CHADDS, PA 19317
(515) 302-4931
(859) 203-3079
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
39697
IA
2084P0800X
Psychiatry Physician
Primary
MD441175
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0159608
—
IA
01
—
07466
WELLMARK BCBS
IA
Enumeration date
01/17/2009
Last updated
11/12/2020
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