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Individual

DR. RICHARD MARK LOOMIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
330 BROOKLINE AVE # FD-407, BOSTON, MA 02215-5400
(617) 667-9501
Mailing address
150 BROOKLINE AVE UNIT 402, BOSTON, MA 02215-3931
(607) 279-9256

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
236752
MA
207L00000X
Anesthesiology Physician
BP10029238
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4656869634
MYUTMB 4656869634
Enumeration date
08/05/2007
Last updated
10/01/2008
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