Provider Demographics
NPI:1427013895
Name:LORFEL, RONALD S (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:S
Last Name:LORFEL
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 1:29927 6 MILE RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3670
Mailing Address - Country:US
Mailing Address - Phone:734-522-0800
Mailing Address - Fax:734-522-1236
Practice Address - Street 1:29927 6 MILE RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3670
Practice Address - Country:US
Practice Address - Phone:734-522-0800
Practice Address - Fax:734-522-1236
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRL030014207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI180820549OtherBCBS PIN
MI540Q208880OtherBLUE CROSS VISION
MIRL030014OtherSTATE LICENSE
MI1241896Medicaid
MIOH24256OtherBCBS GROUP IDENTIFIER
MI0820689OtherMR ADVANTAGE PIN
MIC0GXQOtherBLUE CROSS SUBMITTER ID
MI0184600001Medicare NSC
MI180820549OtherBCBS PIN
MIC0GXQOtherBLUE CROSS SUBMITTER ID
MI180009081Medicare PIN
MIB44355Medicare UPIN