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Individual

DR. CHARLES BENNY LOVELADY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D., FACS

Contact information

Practice address
390 S MAIN ST STE 302, ROCKY MOUNT, VA 24151-1766
(540) 489-6348
(540) 489-6595
Mailing address
1088 MIRIAM HILL DR, ROCKY MOUNT, VA 24151-5967
(540) 489-6348
(540) 489-6595

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
101243927
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
112843
AL
01
51049416
BLUE CROSS
AL
Enumeration date
07/26/2006
Last updated
03/17/2018
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