Provider Demographics
NPI:1841394574
Name:LOEB, ELIZABETH VOGELEY (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:VOGELEY
Last Name:LOEB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:LOEB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:515 FAIRMOUNT AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-8518
Mailing Address - Country:US
Mailing Address - Phone:443-471-0473
Mailing Address - Fax:410-584-1884
Practice Address - Street 1:1838 GREENE TREE RD STE 225B
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-7115
Practice Address - Country:US
Practice Address - Phone:443-471-0473
Practice Address - Fax:410-584-1884
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD51552207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS1210005OtherCAREFIRST REGIONAL
MDKJ68ME/547004256OtherCAREFIRST MARYLAND
MD144904360Medicaid
MDKJ68ME/547004256OtherCAREFIRST MARYLAND
166929ZR0ZMedicare PIN
MD716LF588Medicare PIN
MD157676Medicare PIN