Provider Demographics
NPI:1255320354
Name:LOVELLO, KATHERINE T (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:T
Last Name:LOVELLO
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:10709 SPOTSYLVANIA AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-2674
Mailing Address - Country:US
Mailing Address - Phone:540-898-8001
Mailing Address - Fax:540-898-2127
Practice Address - Street 1:10709 SPOTSYLVANIA AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-2674
Practice Address - Country:US
Practice Address - Phone:540-898-8001
Practice Address - Fax:540-898-2127
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101049279207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F62674Medicare UPIN