Provider Demographics
NPI:1871688838
Name:LOVEGREN, EDITH (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:EDITH
Middle Name:
Last Name:LOVEGREN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6311 E 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-2821
Mailing Address - Country:US
Mailing Address - Phone:303-333-6434
Mailing Address - Fax:303-333-6505
Practice Address - Street 1:6311 E 14TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-2821
Practice Address - Country:US
Practice Address - Phone:303-333-6434
Practice Address - Fax:303-333-6505
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31930207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine