Provider Demographics
NPI:1548324619
Name:LOVELAND, PAMELA MARY (MD)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:MARY
Last Name:LOVELAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:PAMELA
Other - Middle Name:MARY
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2 MAYNARD ST
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23661-3434
Mailing Address - Country:US
Mailing Address - Phone:937-581-0559
Mailing Address - Fax:
Practice Address - Street 1:45 PINE ST
Practice Address - Street 2:1 MEDOPS SQ
Practice Address - City:LANGLEY AFB
Practice Address - State:VA
Practice Address - Zip Code:23665-2025
Practice Address - Country:US
Practice Address - Phone:757-764-8501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH010258207P00000X
OH090193207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine