MEDICARE: HAEJIN LOVELACE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1336082601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAEJIN LOVELACE

Provider Business Mailing Address
First Line	:	3027 BRELLON LN
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-3496
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3921 SUNSET RIDGE RD STE 202
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-6677
Country	:	US
Telephone Number	:	984-974-3900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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Directions to “ HAEJIN LOVELACE ” Practice Location

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