Basic Information
| Provider Information | |||||||||
| NPI: | 1083797955 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOFTON | ||||||||
| FirstName: | RAYGAN | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1111 BENFIELD BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | MILLERSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211083002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107295100 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 24A MAGOTHY BEACH RD | ||||||||
| Address2: | |||||||||
| City: | PASADENA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211224428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102552700 | ||||||||
| FaxNumber: | 4104371962 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2006 | ||||||||
| LastUpdateDate: | 02/01/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | D64565 | MD | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 208595 | 01 | MD | JHHC PRIORITY PARTNERS | OTHER | 8170793 | 01 | MD | MAMSI PRIMARY CARE | OTHER | 925556-01 | 01 | MD | CAREFIRST MD RENDERING PROVIDER NUMBER | OTHER | 7605-0093 | 01 | MD | CAREFIRST BLUECHOICE | OTHER | 1498393 | 01 | MD | CIGNA PIN | OTHER | 1604419 | 01 | MD | AETNA HMO | OTHER | P00602813 | 01 | MD | RAILROAD MEDICARE | OTHER | 412709900 | 05 | MD | MEDICAID | P17925 | 01 | MD | CAREFIRST MPOS | OTHER | 2170793 | 01 | MD | MAMSI SPECIALIST | OTHER | 7554954 | 01 | MD | AETNA PPO | OTHER |