Individual
LORENZO DOW MCKNELLY
Active
Individual
LORENZO DOW MCKNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R4N29
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-04436
UNITED HEALTHCARE
MO
01
—
10118C002
BC/BS
MO
01
—
105908
MERCY HEALTH PLANS
MO
01
—
109986
BLUE CHOICE
MO
01
—
110147220
RR MEDICARE
MO
01
—
17066
GROUP HEALTH PLAN
MO
05
—
242956837
—
MO
01
—
5833167
AETNA
MO
Enumeration date
08/21/2006
Last updated
08/08/2012
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