Healthcare Provider Details

I. General information

NPI: 1851948210
Provider Name (Legal Business Name): ROBERT EDWARD LOREK PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2019
Last Update Date: 12/07/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W MEETING ST
LANCASTER SC
29720-2202
US

IV. Provider business mailing address

PO BOX 749306
ATLANTA GA
30374-9306
US

V. Phone/Fax

Practice location:
  • Phone: 803-286-1214
  • Fax:
Mailing address:
  • Phone: 843-884-6424
  • Fax: 843-884-6994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number13504
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3357
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: