Individual
WALTER KENNETH LOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1034 MAIN ST, WALDOBORO, ME 04572-6037
(207) 832-5813
(207) 832-3070
Mailing address
PO BOX 309, WALDOBORO, ME 04572
(207) 832-5813
(207) 832-3070
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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