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General NPI Number Information
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NPI Number | 1699459719
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Entity Type | Individual
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Provider Name | JAKE TIMOTHY LOEWENSTEIN PA-C
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Gender | Male
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Dates
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Enumeration Date | 06/09/2023
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 6820 PARKDALE PL STE 212
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City | INDIANAPOLIS
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State | IN
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Zip | 46254-6600
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Country | US
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Telephone | 317-216-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 8185 SPENCER CT
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City | PLAINFIELD
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State | IN
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Zip | 46168-5672
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Country | US
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Telephone | 208-615-6958
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10005028A
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License Number State | IN
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