Provider Demographics
NPI:1275631467
Name:LOVINS, TERESA L (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:L
Last Name:LOVINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4365 N RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-1124
Mailing Address - Country:US
Mailing Address - Phone:812-900-2883
Mailing Address - Fax:
Practice Address - Street 1:2530 SANDCREST BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47203-3060
Practice Address - Country:US
Practice Address - Phone:812-900-2883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01041593207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN351907774NSOtherDONLEY
IN351907774109OtherCARESOURCE
080179723OtherMEDICARE RAILROAD
IN100333580Medicaid
IN003803OtherSIHO
IN351907774014OtherTRICARE
IN000000208344OtherBLUE CROSS
IN351907774109OtherCARESOURCE
F31408Medicare UPIN