Provider Demographics
NPI:1316934102
Name:PEKAREK, LORI E (MD)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:E
Last Name:PEKAREK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 W WHITE RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-4988
Mailing Address - Country:US
Mailing Address - Phone:877-668-5621
Mailing Address - Fax:
Practice Address - Street 1:253 SAGAMORE PKWY W
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906-1501
Practice Address - Country:US
Practice Address - Phone:765-448-8000
Practice Address - Fax:765-446-7023
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059463A207Q00000X, 208D00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000677223OtherANTHEM PIN / ARNETT CLINIC, LLC URGENT CARE
000000342498OtherANTHEM BLUE CROSS BLUE SH
IN000000544391OtherANTHEM PIN FOR ARNETT
IN200884370Medicaid
92631OtherGEISINGER HEALTH PLAN
IN9292098OtherAETNA PROVIDER NUMBER
IN000000677223OtherANTHEM PIN / ARNETT CLINIC, LLC URGENT CARE
000000342498OtherANTHEM BLUE CROSS BLUE SH
IN200884370Medicaid
IN815500F3Medicare PIN
INH63313Medicare UPIN