Provider Demographics
NPI:1730110966
Name:LOEB, ROBERT A (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:LOEB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1105 N POINT BLVD
Mailing Address - Street 2:SUITE 323
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-3419
Mailing Address - Country:US
Mailing Address - Phone:410-282-5954
Mailing Address - Fax:410-282-3080
Practice Address - Street 1:1105 N POINT BLVD
Practice Address - Street 2:SUITE 323
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-3419
Practice Address - Country:US
Practice Address - Phone:410-282-5954
Practice Address - Fax:410-282-3080
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0022792207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD407221900 772411000Medicaid
DCR589 0002OtherCAREFIRST
GADC6317 P0021234OtherRAILROAD MEDICARE
DCR589 0002OtherCAREFIRST