Individual
DR. GLEN S LOVELACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
M6570
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010002170
BLUE SHIELD
ID
05
—
003795800
—
ID
01
—
37382
BLUE CROSS
ID
Enumeration date
06/19/2006
Last updated
08/23/2017
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