Individual
CHARLES FREDERICK LOVELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
142 W. YORK STREET, SUITE 905, NORFOLK, VA 23510-2015
(757) 623-3038
(757) 623-0101
Mailing address
142 W. YORK STREET, SUITE 905, NORFOLK, VA 23510-2015
(757) 623-3038
(757) 623-0101
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101027439
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006074936
—
VA
01
—
006354
ANTHEM BLUE CROSS BLUE SH
VA
01
—
111936953
MEDICARE PTAN
—
Enumeration date
09/15/2006
Last updated
03/07/2012
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