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General NPI Number Information
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NPI Number | 1306848445
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Entity Type | Individual
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Provider Name | PETER E LOEB MD
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Gender | Male
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 05/07/2009
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Provider Practice Location Address
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Address Line | 1911 MICCOSUKEE RD
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5321
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Country | US
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Telephone | 850-878-2549
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Fax | 850-431-6341
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Provider Business Mailing Address
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Address Line | 1911 MICCOSUKEE RD
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5321
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Country | US
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Telephone | 850-878-2549
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Fax | 850-431-6341
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME0059656
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License Number State | FL
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