Provider Demographics
NPI:1306836499
Name:LOEWEN, GREGORY M (DO)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:M
Last Name:LOEWEN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:571 SAINT JOSEPHS BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-3230
Mailing Address - Country:US
Mailing Address - Phone:607-271-2050
Mailing Address - Fax:607-873-1244
Practice Address - Street 1:600 ROE AVE FL 4
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14905-1676
Practice Address - Country:US
Practice Address - Phone:607-271-3780
Practice Address - Fax:607-271-3894
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2023-07-10
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Provider Licenses
StateLicense IDTaxonomies
NY165241207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB83044Medicare UPIN