Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2292 | SD |
N | 111NI0900X | Internist | 2292 | SD |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 2292 | SD |
Y | 207U00000X | Nuclear Medicine Specialist | 2292 | SD |
NPI | 1497751341 |
---|---|
Provider Name | Fred Clinton Lovrien |
First Address | Sioux Falls, SD 57117-5074 |
Second Address | Sioux Falls, SD 57105-0407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2005 |
Last Update Date | 22/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6620048 | (05) | SD |
D25438 | (02) |