Provider Demographics
NPI:1184770083
Name:LOEWE, CHARLES J (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:J
Last Name:LOEWE
Suffix:
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 1:3325 S TAMIAMI TRL STE 200
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5142
Mailing Address - Country:US
Mailing Address - Phone:941-952-9223
Mailing Address - Fax:941-955-0642
Practice Address - Street 1:3325 S TAMIAMI TRL STE 200
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5142
Practice Address - Country:US
Practice Address - Phone:941-952-9223
Practice Address - Fax:941-955-0642
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME43998207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL64525AOtherMEDICARE NUMBER
FLME43998OtherMEDICAL LICENSE
FLME43998OtherMEDICAL LICENSE