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Individual
ANDREW S LOVELL
Active
Individual
ANDREW S LOVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001090A
IN
363AS0400X
Surgical Physician Assistant
10001090A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000698304
ANTHEM
IN
Enumeration date
06/09/2009
Last updated
12/18/2020
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