Provider Demographics
NPI:1609851732
Name:LOESER, RICHARD FRANK JR (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:FRANK
Last Name:LOESER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12008 WICKER DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-7448
Mailing Address - Country:US
Mailing Address - Phone:336-480-4377
Mailing Address - Fax:
Practice Address - Street 1:3300 THURSTON BUILDING CB#7280
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-966-7042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29324207R00000X
NC000029324207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7015751OtherAETNA
NC806757OtherPARTNERS
VA10178908Medicaid
NC52461OtherBCBS
NCE4473OtherMEDCOST
WV3810003037Medicaid
NC8952461Medicaid
SCQ29324Medicaid
NC52461OtherBCBS
WV3810003037Medicaid