Healthcare Provider Details

I. General information

NPI: 1831140854
Provider Name (Legal Business Name): WILLIAM D LOVELAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1828 S MILLENIUM WAY STE 300
MERIDIAN ID
83642-5036
US

IV. Provider business mailing address

1828 S MILLENIUM WAY STE 300
MERIDIAN ID
83642-5036
US

V. Phone/Fax

Practice location:
  • Phone: 208-895-8775
  • Fax: 208-895-1775
Mailing address:
  • Phone: 208-895-8775
  • Fax: 208-895-1775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberM7580
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: