Provider Demographics
NPI:1275557464
Name:LOEWENSTEIN, LINDA L (DO)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:L
Last Name:LOEWENSTEIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:50 N PERRY ST
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48342-2217
Mailing Address - Country:US
Mailing Address - Phone:248-338-5516
Mailing Address - Fax:248-338-5547
Practice Address - Street 1:180 N ORTONVILLE RD
Practice Address - Street 2:
Practice Address - City:ORTONVILLE
Practice Address - State:MI
Practice Address - Zip Code:48462-8575
Practice Address - Country:US
Practice Address - Phone:248-627-3535
Practice Address - Fax:248-627-9134
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101009375207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3449811-11Medicaid
MI0M20610009Medicare ID - Type Unspecified
MI3449811-11Medicaid