Provider Demographics
NPI:1285612291
Name:LOREMAN, LORIE (DO)
Entity type:Individual
Prefix:MS
First Name:LORIE
Middle Name:
Last Name:LOREMAN
Suffix:
Gender:F
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:PO BOX 601743
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1743
Mailing Address - Country:US
Mailing Address - Phone:843-777-7863
Mailing Address - Fax:843-777-7102
Practice Address - Street 1:101 S RAVENEL ST STE 230
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2624
Practice Address - Country:US
Practice Address - Phone:843-777-7863
Practice Address - Fax:843-777-7873
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDO92647207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ705858Medicaid
AZ705858Medicaid