Provider Demographics
NPI:1689677908
Name:LOVERIA, JOSE T (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:T
Last Name:LOVERIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1671
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21501-1671
Mailing Address - Country:US
Mailing Address - Phone:240-964-8515
Mailing Address - Fax:240-964-8925
Practice Address - Street 1:12502 WILLOWBROOK RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-6491
Practice Address - Country:US
Practice Address - Phone:240-964-8921
Practice Address - Fax:240-964-8925
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0050844207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
544222-01OtherBCBS POS
0401812OtherUNITED HEALTHCARE
MD325901300Medicaid
P12814OtherBCBS POS PRIMARY
WV0079534000Medicaid
110144132OtherMEDICARE RAILROAD
846868OtherMDIPA/OPTIMUM CHOICE
1040111861OtherCIGNA
W3990004OtherBCBS FEDERAL
W3990004OtherBCBS FEDERAL