Provider Demographics
NPI:1164422432
Name:PO, LORENVER O (MD)
Entity Type:Individual
Prefix:DR
First Name:LORENVER
Middle Name:O
Last Name:PO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:15 HOSPITAL DR.
Mailing Address - Street 2:WESTERN MASS PHYSICIAN ASSOCIATES INC
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040
Mailing Address - Country:US
Mailing Address - Phone:413-533-3470
Mailing Address - Fax:413-533-6859
Practice Address - Street 1:2 HOSPITAL DR SUITE 101
Practice Address - Street 2:HOLYOKE ASSOCIATES IN INTERNAL MEDICINE
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040
Practice Address - Country:US
Practice Address - Phone:413-536-8924
Practice Address - Fax:413-532-9141
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2010-04-09
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Provider Licenses
StateLicense IDTaxonomies
MA215625207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
692919OtherHARVARD PILGRIM
J25173OtherBC/BS OF MASS
MA0195511Medicaid
043202198OtherHMC - PPO
MA110246843OtherMEDICARE RAILROAD
6439469001OtherCIGNA
043202198OtherBEECH STREET
043202198OtherFIRST HEALTH
043202198OtherMULTI-PLAN
043202198012OtherTRICARE
J25173OtherHMO BLUE
215625OtherCONNECTICARE OF MA
043202198OtherGREAT WEST HEALTH PLAN
043202198OtherCONSOLIDATED HEALTH PLAN
975688OtherNETWORK HEALTH
000000023253OtherBOSTON MEDICAL CENTER HNP
043202198OtherHEALTH CARE VALUE MGMT
30889OtherHEALTH NEW ENGLAND
30889OtherHEALTH NEW ENGLAND
G66160Medicare UPIN