Provider Demographics
NPI:1518967991
Name:LOEBEL, GRETCHEN E (MD)
Entity Type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:E
Last Name:LOEBEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GRETCHEN
Other - Middle Name:E
Other - Last Name:LOEBEL-WEST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:30 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2052
Mailing Address - Country:US
Mailing Address - Phone:413-586-9866
Mailing Address - Fax:413-923-9306
Practice Address - Street 1:30 LOCUST ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060
Practice Address - Country:US
Practice Address - Phone:413-586-9866
Practice Address - Fax:413-923-9306
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA221179207V00000X
CT041366207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
043202198OtherHEALTH CARE VALUE MANAGEM
J27723OtherBLUE CROSS BLUE SHEILD
043202198OtherGREAT WEST HEALTH PLAN
043202198OtherCBA
043202198OtherHMC - PPO
7479928OtherCIGNA
J27723OtherBLUE CARE 65
043202198OtherFIRST HEALTH
MA2070014Medicaid
041366OtherCONNECTICARE OF MA
77086OtherCHILDRENS MEDICAL PLAN
CT001413666Medicaid
043202198OtherBEACH STREET
14838OtherHARVARD/PILGRIM
0000000028929OtherBOSTON MEDICAL CENTER - H
043202198OtherCONSOLIDATED HEALTH PLAN
34835OtherHEALTH NEW ENGLAND
MAA37144Medicare ID - Type Unspecified
H89167Medicare UPIN
CT001413666Medicaid