MEDICARE: LORICEL ESCOTE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	LE067373	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1106313771	OTHER	MI	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1689649048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORICEL ESCOTE MD

Provider Business Mailing Address
First Line	:	23900 ORCHARD LAKE RD
Second Line	:	SUITE 100
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48336-2501
Country	:	US
Telephone Number	:	248-476-6209
Fax Number	:	248-476-6237

Provider Business Practice Location Address
First Line	:	23900 ORCHARD LAKE RD
Second Line	:	SUITE 100
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48336-2501
Country	:	US
Telephone Number	:	248-476-6209
Fax Number	:	248-476-6237

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	11/01/2012

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