Provider Demographics
NPI:1427235605
Name:LOOMER, MEGAN (MD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:LOOMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:130 TOWN CENTER DR
Mailing Address - Street 2:100
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-1744
Mailing Address - Country:US
Mailing Address - Phone:248-585-8265
Mailing Address - Fax:248-585-8266
Practice Address - Street 1:3601 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6712
Practice Address - Country:US
Practice Address - Phone:248-551-2037
Practice Address - Fax:248-551-5010
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301090464207V00000X
MA242478207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology