Provider Demographics
NPI:1871513234
Name:LOEHR, STEPHEN P
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:P
Last Name:LOEHR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 WESTCHASE BLVD
Mailing Address - Street 2:SUITE 390
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-3938
Mailing Address - Country:US
Mailing Address - Phone:919-834-2767
Mailing Address - Fax:919-834-0234
Practice Address - Street 1:2501 WESTON PKWY
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-5598
Practice Address - Country:US
Practice Address - Phone:919-677-9729
Practice Address - Fax:919-677-9721
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC97014662085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8911312Medicaid
G70381Medicare UPIN
NC8911312Medicaid