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Individual

DR. BRIAN GEORGE LODER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM, CWS

Contact information

Practice address
43391 COMMONS DR, CLINTON TOWNSHIP, MI 48038-1109
(586) 329-3895
(586) 329-3916
Mailing address
15760 19 MILE RD STE E, CLINTON TOWNSHIP, MI 48038-6319
(586) 329-3895
(586) 329-3916

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
BL001662
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10040760007
WELLNESS
MI
01
101706
GREAT LAKES HEALTH PLAN
MI
01
107320
PREFERRED/CARE CHOICES
MI
01
234010003
CIGNA
MI
01
4616745
MOLINA
MI
05
4616745
MI
01
4638660
AETNA
MI
01
4855057230
BLUE CARE NETWORK
MI
01
C3980
MCARE
MI
01
P00777182
RAILROAD MEDICARE
MI
01
U53759
HEALTH ALLIANCE PLAN
MI
Enumeration date
06/16/2005
Last updated
11/17/2022
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