Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 0101048993 | VA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 0101048993 | VA |
NPI | 1518986348 |
---|---|
Provider Name | Dr. Jeffrey L Lovallo |
First Address | Arlington, VA 22206-2905 |
Second Address | Arlington, VA 22206-2905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 07/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0005 | CIGNA ID (01) | |
00196 | UNITED ID (01) | |
0738321 | AETNA HMO (01) | |
074829 | ANTHEM ID (01) | |
148820100 | DEPT OF LABOR ID (01) | |
25090039 | BLUE CROSS BLUE SHIELD ID (01) | |
4304627 | AETNA PPO (01) | |
502350 | NCPPO (01) | |
B74650 | (02) | VA |