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General NPI Number Information
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NPI Number | 1336550748
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Entity Type | Individual
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Provider Name | LOREN R KAISER MD
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Gender | Female
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Dates
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Enumeration Date | 05/20/2014
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Last Update Date | 01/29/2020
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Provider Practice Location Address
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Address Line | 30 MEDICAL PARK SUITE 221
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City | WHEELING
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State | WV
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Zip | 26003
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Country | US
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Telephone | 304-243-8850
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Fax | 304-243-8437
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Provider Business Mailing Address
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Address Line | 1 MEDICAL PARK PHYSICIAN BILLING DEPT. NTTC
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City | WHEELING
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State | WV
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Zip | 26003
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Country | US
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Telephone | 304-243-7181
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Fax | 304-243-1131
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 27088
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License Number State | WV
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