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Individual
WALTER KENNETH LOVE
Active
Individual
WALTER KENNETH LOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
012987
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043833726
TAX ID #
ME
01
—
100367
ANTHEM
ME
01
—
1396848297
GROUP NPI #
ME
05
—
308080099
—
ME
Enumeration date
08/02/2005
Last updated
12/01/2017
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