Provider Demographics
NPI:1518913896
Name:LOVE, SANDRA R (MD)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:R
Last Name:LOVE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:ONE INDEPENDENCE POINTE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4566
Mailing Address - Country:US
Mailing Address - Phone:864-797-6044
Mailing Address - Fax:864-797-6198
Practice Address - Street 1:877 W FARIS RD
Practice Address - Street 2:SUITE D
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4254
Practice Address - Country:US
Practice Address - Phone:864-455-9050
Practice Address - Fax:864-455-9017
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2011-06-24
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Provider Licenses
StateLicense IDTaxonomies
SC16551207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC576007863063OtherBCBS OF SC
SC165519Medicaid
SC5237092OtherAETNA
SCP00186717OtherRR MEDICARE
SC576007863063OtherBLUE CHOICE OF SC
SC576007863063OtherBLUE CHOICE OF SC
SCP00186717OtherRR MEDICARE
SC165519Medicaid