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1649224106

NPI Code Detail

MEDICARE: MR. JOHN W LOAR PT

MEDICARE: MR. JOHN W LOAR PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	19139	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00094708	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2114693	OTHER		MAMSI
3	0012	OTHER		CAREFIRST BCBS OF DC/NCA
4	62023901	OTHER	MD	BLUE CROSS BLUE SHIELD
6	1017320	OTHER	WV	WORKERS' COMPENSATION
7	7720660	OTHER		AETNA

General Provider Information

NPI Number	:	1649224106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN W LOAR PT

Provider Business Mailing Address
First Line	:	11801 INDUSTRIAL PARK ST
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-5139
Country	:	US
Telephone Number	:	301-729-3485
Fax Number	:	301-729-0158

Provider Business Practice Location Address
First Line	:	11801 INDUSTRIAL PARK ST
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-5139
Country	:	US
Telephone Number	:	301-729-3485
Fax Number	:	301-729-0158

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	07/08/2007

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Directions to “ MR. JOHN W LOAR PT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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