Provider Demographics
NPI:1467563395
Name:LOEBL, ANNE M (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:M
Last Name:LOEBL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3614 J DEWEY GRAY CIR
Mailing Address - Street 2:SUITE B
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-6602
Mailing Address - Country:US
Mailing Address - Phone:706-447-3930
Mailing Address - Fax:706-447-3933
Practice Address - Street 1:3614 J DEWEY GRAY CIR
Practice Address - Street 2:SUITE B
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6602
Practice Address - Country:US
Practice Address - Phone:706-447-3930
Practice Address - Fax:706-447-3933
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-12-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA022436207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00426357EMedicaid
GA07BBSTVMedicare PIN
GA00426357EMedicaid