Healthcare Provider Details

I. General information

NPI: 1437129988
Provider Name (Legal Business Name): JAMES T LOVE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 12/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 S DENWOOD ST
DEARBORN MI
48124-1310
US

IV. Provider business mailing address

DEPT 259301 P O BOX 67000
DETROIT MI
48267-2593
US

V. Phone/Fax

Practice location:
  • Phone: 734-467-4150
  • Fax: 313-791-2432
Mailing address:
  • Phone: 734-467-4150
  • Fax: 313-791-2432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number4301050447
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: