Provider Demographics
NPI:1538545397
Name:MELISSA LOUGHNEY M.D., LLC
Entity type:Organization
Organization Name:MELISSA LOUGHNEY M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUGHNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-320-3361
Mailing Address - Street 1:6400 GOLDSBORO RD
Mailing Address - Street 2:STE 330
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-5826
Mailing Address - Country:US
Mailing Address - Phone:301-320-3361
Mailing Address - Fax:301-320-0171
Practice Address - Street 1:6400 GOLDSBORO RD
Practice Address - Street 2:STE 330
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-5826
Practice Address - Country:US
Practice Address - Phone:301-320-3361
Practice Address - Fax:301-320-0171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-04
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0078947207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G59700Medicare UPIN
277357YGA4Medicare PIN