Provider Demographics
NPI:1669665253
Name:LORETZ, ADRIENNE (DPM)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:LORETZ
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3461 WARRENSVILLE CENTER RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5260
Mailing Address - Country:US
Mailing Address - Phone:216-561-3303
Mailing Address - Fax:216-561-7790
Practice Address - Street 1:3461 WARRENSVILLE CENTER RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-5260
Practice Address - Country:US
Practice Address - Phone:216-561-3303
Practice Address - Fax:216-561-7790
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.003520213ES0103X
OH36003520213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH6736110001Medicare NSC