Provider Demographics
NPI:1700153863
Name:DR. STEWART S. LOEB, PC
Entity Type:Organization
Organization Name:DR. STEWART S. LOEB, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEWART
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:LOEB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:301-577-6556
Mailing Address - Street 1:7400 RIVERDALE RD
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1136
Mailing Address - Country:US
Mailing Address - Phone:301-577-6556
Mailing Address - Fax:301-577-6558
Practice Address - Street 1:7400 RIVERDALE RD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-1136
Practice Address - Country:US
Practice Address - Phone:301-577-6556
Practice Address - Fax:301-577-6558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1496PT111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD664189Medicare PIN