Basic Information
| Provider Information | |||||||||
| NPI: | 1508181520 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOEFFLER | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | SCHWAB | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 193 STONER AVE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | WESTMINSTER | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211575587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107512510 | ||||||||
| FaxNumber: | 4107512515 | ||||||||
| Practice Location | |||||||||
| Address1: | 193 STONER AVE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | WESTMINSTER | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211575587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107512510 | ||||||||
| FaxNumber: | 4107512515 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2010 | ||||||||
| LastUpdateDate: | 06/02/2016 | ||||||||
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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 | 207RE0101X | D76740 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
ID Information
| ID | Type | State | Issuer | Description | 330030700 | 05 | MD | MEDICAID |