Provider Demographics
NPI:1295140937
Name:LORIO, MARCO ANTONIO (MD)
Entity type:Individual
Prefix:DR
First Name:MARCO
Middle Name:ANTONIO
Last Name:LORIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MARCO
Other - Middle Name:ANTONIO
Other - Last Name:LORIO RUGAMA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:500 W BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4008
Mailing Address - Country:US
Mailing Address - Phone:406-543-7271
Mailing Address - Fax:406-327-1834
Practice Address - Street 1:500 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4008
Practice Address - Country:US
Practice Address - Phone:406-543-7271
Practice Address - Fax:406-327-1834
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT78112207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine