Provider Demographics
NPI:1972780013
Name:LOY, VERONICA MAE (DO)
Entity type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:MAE
Last Name:LOY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:VERONICA
Other - Middle Name:MAE
Other - Last Name:TENCATE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-955-6830
Mailing Address - Fax:414-955-6214
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:DIVISION OF GASTROENTEROLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-955-6830
Practice Address - Fax:414-955-6214
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036119924207RI0008X
WI57323207RI0008X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1972780013Medicaid
WI68086 1265Medicare PIN
WI1972780013Medicaid