Healthcare Provider Details

I. General information

NPI: 1811999428
Provider Name (Legal Business Name): MICHAEL R LOEWE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 HENNESSY BLVD OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER
BATON ROUGE LA
70808-4375
US

IV. Provider business mailing address

PO BOX 95020 PROFESSIONAL EMERGENCY PHYSICIAN ASSOCIATES LLC
NEW ORLEANS LA
70195-5020
US

V. Phone/Fax

Practice location:
  • Phone: 225-765-7790
  • Fax: 630-734-1560
Mailing address:
  • Phone: 630-734-0200
  • Fax: 630-734-1560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number025632
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number025632
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: