Provider Demographics
NPI:1033372628
Name:MOREY, FREDERICK L (DO)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:L
Last Name:MOREY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20455 LORAIN RD STE 104B
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-3529
Mailing Address - Country:US
Mailing Address - Phone:234-525-6999
Mailing Address - Fax:234-525-6999
Practice Address - Street 1:20455 LORAIN RD STE 104B
Practice Address - Street 2:
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-3529
Practice Address - Country:US
Practice Address - Phone:234-525-6999
Practice Address - Fax:234-525-6999
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-009830207R00000X
OH34.00983208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810020456Medicaid
OH000000714831OtherANTHEM
OH3111519Medicaid
WV3810020456Medicaid