Healthcare Provider Details

I. General information

NPI: 1457300675
Provider Name (Legal Business Name): MICHAEL R LOEW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 08/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 N NEVADA AVE
COLORADO SPRINGS CO
80907-6831
US

IV. Provider business mailing address

1241 W MINERAL AVE SUITE 100
LITTLETON CO
80120-5685
US

V. Phone/Fax

Practice location:
  • Phone: 719-766-5333
  • Fax: 719-766-5651
Mailing address:
  • Phone: 303-759-0854
  • Fax: 303-759-0864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number37162
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License Number37162
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: