Provider Demographics
NPI:1740577790
Name:LOREE, STACY RENE (DO)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:RENE
Last Name:LOREE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:42557 WOODWARD AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-5206
Mailing Address - Country:US
Mailing Address - Phone:248-333-1170
Mailing Address - Fax:248-333-1175
Practice Address - Street 1:42557 WOODWARD AVE STE 200
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-5206
Practice Address - Country:US
Practice Address - Phone:248-333-1170
Practice Address - Fax:248-333-1175
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101019160207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine