Provider Demographics
NPI:1043870751
Name:LORE, AL VITO (MD)
Entity type:Individual
Prefix:
First Name:AL
Middle Name:VITO
Last Name:LORE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:7445 ALLEN ROAD STE 190
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-1993
Mailing Address - Country:US
Mailing Address - Phone:313-382-0244
Mailing Address - Fax:313-382-1640
Practice Address - Street 1:7445 ALLEN ROAD SUITE 190
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-4089
Practice Address - Country:US
Practice Address - Phone:313-382-0244
Practice Address - Fax:313-382-1640
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2024-01-31
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Provider Licenses
StateLicense IDTaxonomies
MI4301509730207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology