Healthcare Provider Details
I. General information
NPI: 1871989202
Provider Name (Legal Business Name): FREDERICK WESTON LOEHR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/13/2015
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1215 LEE ST
CHARLOTTESVILLE VA
22908-0816
US
IV. Provider business mailing address
8100 GATES BLUFF TER
CHESTERFIELD VA
23832-6340
US
V. Phone/Fax
- Phone: 434-924-3627
- Fax:
- Phone: 804-380-4798
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VM0101X |
| Taxonomy | Maternal & Fetal Medicine Physician |
| License Number | 0101272466 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: