Individual
DR. MICHAEL W. LOES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11047 N 19TH AVE, PHOENIX, AZ 85029-4816
(602) 944-2222
(602) 331-2499
Mailing address
7402 E WETHERSFIELD RD, SCOTTSDALE, AZ 85260-4719
(480) 250-1438
(602) 331-2499
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
11336
AZ
207RA0401X
Addiction Medicine (Internal Medicine) Physician
MD11336
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
188372200
OWCP FEDERAL COMPENSATION
AZ
01
—
25492002
AHCCCS
AZ
01
—
AZ0397010
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
03/02/2007
Last updated
02/17/2012
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