Provider Demographics
NPI:1386633188
Name:LORCH, FRANK E IV (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:E
Last Name:LORCH
Suffix:IV
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:PO BOX 602148
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2148
Mailing Address - Country:US
Mailing Address - Phone:704-863-4878
Mailing Address - Fax:704-896-0387
Practice Address - Street 1:3030 RANDOLPH ROAD
Practice Address - Street 2:SUITE 105
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1365
Practice Address - Country:US
Practice Address - Phone:704-863-4878
Practice Address - Fax:704-896-0387
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200201121208100000X, 2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1386633188Medicaid
NC891321AMedicaid
SCN01126Medicaid
NC2010195CMedicare PIN
NCNCD435BMedicare PIN
NC1386633188Medicaid
NCNCD435AMedicare PIN
G10296Medicare UPIN
NC2010195BMedicare PIN