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General NPI Number Information
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NPI Number | 1407858079
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Entity Type | Individual
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Provider Name | LORRAINE WEAN MD
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Gender | Female
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 10/14/2010
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Provider Practice Location Address
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Address Line | 300 E BOYD AVE STE 250
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City | GREENFIELD
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State | IN
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Zip | 46140-2845
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Country | US
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Telephone | 317-467-4500
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Fax | 317-477-6321
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Provider Business Mailing Address
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Address Line | PO BOX 129
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City | GREENFIELD
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State | IN
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Zip | 46140-0129
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Country | US
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Telephone | 317-468-6270
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Fax | 317-468-6268
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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 | 01038518A
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License Number State | IN
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