Provider Demographics
NPI:1508038639
Name:LOVELY, SUNEE RANAE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNEE
Middle Name:RANAE
Last Name:LOVELY
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:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:ME
Mailing Address - Zip Code:04668-0097
Mailing Address - Country:US
Mailing Address - Phone:207-796-2321
Mailing Address - Fax:207-796-2422
Practice Address - Street 1:401 PETER DANA POINT ROAD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:ME
Practice Address - Zip Code:87571
Practice Address - Country:US
Practice Address - Phone:207-796-2321
Practice Address - Fax:207-796-2422
Is Sole Proprietor?:No
Enumeration Date:2008-03-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD8228207Q00000X
IN11013742A207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
HSZ189OtherMEDICARE PART B
320057OtherMEDICARE PART A
NMK3543Medicaid