Provider Demographics
NPI:1144209545
Name:LOVETTE, AMANDA PITMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:PITMAN
Last Name:LOVETTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:PITMAN
Other - Last Name:SIJ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 10100
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:CO
Mailing Address - Zip Code:81416-0008
Mailing Address - Country:US
Mailing Address - Phone:970-546-4000
Mailing Address - Fax:
Practice Address - Street 1:296 STAFFORD LN
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-2243
Practice Address - Country:US
Practice Address - Phone:970-546-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2797208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1711061-01Medicaid
TX8R9140OtherBCBSTX
TX8R9140OtherBCBSTX