Provider Demographics
NPI:1477522753
Name:LOOSIGIAN, STEPHEN R (DO)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:R
Last Name:LOOSIGIAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ELLIOT WAY
Mailing Address - Street 2:HOSPITALIST PROGRAM - ELLIOT HOSPITAL
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3502
Mailing Address - Country:US
Mailing Address - Phone:603-663-2271
Mailing Address - Fax:603-663-2273
Practice Address - Street 1:1 ELLIOT WAY
Practice Address - Street 2:HOSPITALIST PROGRAM - ELLIOT HOSPITAL
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3502
Practice Address - Country:US
Practice Address - Phone:603-663-2271
Practice Address - Fax:603-663-2273
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11378207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH579603OtherCIGNA PIN
NH3206862OtherAETNA PIN
NHH60544OtherANTHEM REFERRING UPIN
NH04Y003749NH02OtherANTHEM ACES #
NH011378OtherTUFTS PIN
NH30221909Medicaid
NH692665OtherHPHC
NH0407214OtherUNITED HC
NHP00014352OtherRR MEDICARE
NHRE6664Medicare PIN
NH04Y003749NH02OtherANTHEM ACES #