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Individual

TIM R LOEWENSTEIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
3280 E LANARK DR, MERIDIAN, ID 83642-5982
(208) 895-8670
(208) 955-0494
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 955-6500
(208) 955-6503

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA349
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
806033700
ID
Enumeration date
05/22/2006
Last updated
07/15/2021
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