Provider Demographics
NPI:1861431348
Name:KENDIS, LOREN S (MD)
Entity type:Individual
Prefix:DR
First Name:LOREN
Middle Name:S
Last Name:KENDIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6555 WILSON MILLS RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MAYFIELD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3435
Mailing Address - Country:US
Mailing Address - Phone:440-442-8313
Mailing Address - Fax:440-442-8316
Practice Address - Street 1:6555 WILSON MILLS RD
Practice Address - Street 2:SUITE 103
Practice Address - City:MAYFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44143-3435
Practice Address - Country:US
Practice Address - Phone:440-442-8313
Practice Address - Fax:440-442-8316
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35046109207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0503682Medicaid
OH0503682Medicaid
OHA80330Medicare UPIN