Provider Demographics
NPI:1093781247
Name:LORAH, KEVIN (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:LORAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 GOOD DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2433
Mailing Address - Country:US
Mailing Address - Phone:717-544-3700
Mailing Address - Fax:
Practice Address - Street 1:690 GOOD DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2433
Practice Address - Country:US
Practice Address - Phone:717-544-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036386E2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3251339OtherAETNA - HMO
PA0440278000OtherAMERIHEALTH 65 / IBC
PA001207188 0009Medicaid
PA0440278000OtherINDEPENDENCE BLUE CROSS
PA1504701OtherGATEWAY
PA822OtherGEISINGER
PA000612151OtherHIGHMARK BLUE SHIELD
PA30002741OtherKEYSTONE MERCY
PA4311453OtherAETNA - NON HMO
PA50056076OtherKEYSTONE HEALTH PLAN CENTRAL
PA000000111533OtherUNISON HEALTHPLAN
PA20013621OtherAMERIHEALTH MERCY
PA50056076OtherCAPITAL BLUE CROSS
PABL2488749OtherDEA