Provider Demographics
NPI:1295719920
Name:LOFTUS, HOS CYRUS (MD)
Entity type:Individual
Prefix:
First Name:HOS
Middle Name:CYRUS
Last Name:LOFTUS
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:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:202 E GROVER ST
Practice Address - Street 2:STE 1
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3977
Practice Address - Country:US
Practice Address - Phone:980-487-2360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2011-000862084N0400X, 2084N0600X
NC1667032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1043506OtherPREFERRED ONE
2347750OtherAMERICAS PPO
132771OtherU CARE
286983700OtherMEDICAL ASSISTANCE MA
2347750OtherARAZ GROUP
6D053CEOtherBLUE CROSS BLUE SHIELD
HP50709OtherHEALTH PARTNERS
0500660OtherMEDICA HEALTH PLANS
WA1295719920Medicaid
164P2LOOtherBLUE CROSS BLUE SHIELD
132771OtherU CARE
2347750OtherARAZ GROUP