Provider Demographics
NPI:1225012628
Name:LOERA, ARNOLD NMI (MD)
Entity type:Individual
Prefix:
First Name:ARNOLD
Middle Name:NMI
Last Name:LOERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:DILLINGHAM
Mailing Address - State:AK
Mailing Address - Zip Code:99576-0130
Mailing Address - Country:US
Mailing Address - Phone:907-842-5201
Mailing Address - Fax:907-842-9250
Practice Address - Street 1:6000 KANAKANAK RD
Practice Address - Street 2:
Practice Address - City:DILLINGHAM
Practice Address - State:AK
Practice Address - Zip Code:99576
Practice Address - Country:US
Practice Address - Phone:907-842-5201
Practice Address - Fax:907-842-9250
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3775207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD01811Medicaid
8EZ305Medicare ID - Type Unspecified
8EZ345Medicare ID - Type Unspecified
8EZ195Medicare ID - Type Unspecified
8EZ325Medicare ID - Type Unspecified
A90013Medicare UPIN
8EZ355Medicare ID - Type Unspecified
8EZ237Medicare ID - Type Unspecified
8EZ295Medicare ID - Type Unspecified
8EZ205Medicare ID - Type Unspecified
8EZ215Medicare ID - Type Unspecified
8EZ255Medicare ID - Type Unspecified
8EZ315Medicare ID - Type Unspecified
8EZ285Medicare ID - Type Unspecified
8EZ225Medicare ID - Type Unspecified
8EZ265Medicare ID - Type Unspecified
8EZ275Medicare ID - Type Unspecified
8EZ335Medicare ID - Type Unspecified
8EZ365Medicare ID - Type Unspecified
AKMD01811Medicaid