MEDICARE: MICHAEL PATRICK LOREY PHYSICIAN ASSISTANT

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	363AM0700X	Medical Physician Assistant

General Provider Information

NPI Number	:	1922631761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL PATRICK LOREY PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	PO BOX 340453
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45434-0453
Country	:	US
Telephone Number	:	937-280-4970
Fax Number	:

Provider Business Practice Location Address
First Line	:	2619 COMMONS BLVD
Second Line	:
City	:	BEAVERCREEK
State	:	OH
Zip	:	45431-3817
Country	:	US
Telephone Number	:	937-280-4970
Fax Number	:

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

Provider Enumeration Date	:	02/20/2020
Last Update Date	:	06/11/2026

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