Healthcare Provider Details
I. General information
NPI: 1326900218
Provider Name (Legal Business Name): LOVELY PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/29/2025
Last Update Date: 11/29/2025
Certification Date: 11/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2695 SUGARLOAF PKWY STE 1200
LAWRENCEVILLE GA
30045-9459
US
IV. Provider business mailing address
2695 SUGARLOAF PKWY STE 1200
LAWRENCEVILLE GA
30045-9459
US
V. Phone/Fax
- Phone: 678-272-4000
- Fax: 866-538-4953
- Phone: 678-272-4000
- Fax: 866-538-4953
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EMERALD
LOVELY
Title or Position: CEO
Credential: MD
Phone: 678-444-7878