Provider Demographics
NPI:1558513176
Name:LOVEJOY, GRACE MARY (MD)
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:MARY
Last Name:LOVEJOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2427 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2128
Mailing Address - Country:US
Mailing Address - Phone:720-232-5323
Mailing Address - Fax:
Practice Address - Street 1:2611 LARIMER ST
Practice Address - Street 2:LOFT
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-8020
Practice Address - Country:US
Practice Address - Phone:720-722-1839
Practice Address - Fax:720-302-0950
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2023-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44751208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO57452784Medicaid
CO57452784Medicaid