Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0100X | Gastroenterologist | 24999 | AZ |
Y | 207RG0100X | Gastroenterologist | 35742 | MN |
N | 207RG0100X | Gastroenterologist | 36565 | WI |
N | 207RG0100X | Gastroenterologist | MD-31755 | IA |
NPI | 1003895590 |
---|---|
Provider Name | Edward Vincent Loftus JR. |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2006 |
Last Update Date | 18/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F44699 | (02) |