Individual
MATTHEW JAMES LOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2355 HIGHWAY 36 W STE 100, ROSEVILLE, MN 55113-3905
(651) 292-2000
Mailing address
2355 HIGHWAY 36 W STE 100, ROSEVILLE, MN 55113-3905
(651) 292-2000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
48953
MN
2085R0204X
Vascular & Interventional Radiology Physician
48953
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34730600
—
WI
05
—
587608000
—
MN
05
—
ENROLLED
—
IA
Enumeration date
07/15/2006
Last updated
06/21/2022
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