Provider Demographics
NPI:1306955463
Name:LORENZO, EMILY E (MD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:E
Last Name:LORENZO
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:PO BOX 602478
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2478
Mailing Address - Country:US
Mailing Address - Phone:704-801-2000
Mailing Address - Fax:704-801-2001
Practice Address - Street 1:10210 COULOAK DR
Practice Address - Street 2:SUITE E
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-7679
Practice Address - Country:US
Practice Address - Phone:704-801-2000
Practice Address - Fax:704-801-2001
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-01102207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1306955463Medicaid
NC5905649Medicaid
NC2060062EMedicare PIN
NCNC2026AMedicare PIN
NCNC2026CMedicare PIN
NCNC2026EMedicare PIN
NCNC2026FMedicare PIN
NC2060062AMedicare PIN
NCP00381964Medicare PIN
NCNC2026DMedicare PIN
NCNC2026GMedicare PIN
NC1306955463Medicaid
NC5905649Medicaid
NC2060062DMedicare PIN
NCNC2026HMedicare PIN
NCNC2026BMedicare PIN
NC2060062BMedicare PIN
NC2060062Medicare PIN