Healthcare Provider Details

I. General information

NPI: 1164417549
Provider Name (Legal Business Name): ANDREW JOSEPH LOVSIN O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11088 N US HWY 15 501 UNIT 925
ABERDEEN NC
28315-2378
US

IV. Provider business mailing address

8614 WESTWOOD CENTER DR FL 9
VIENNA VA
22182-2442
US

V. Phone/Fax

Practice location:
  • Phone: 910-693-1226
  • Fax: 919-314-2787
Mailing address:
  • Phone: 703-847-8899
  • Fax: 571-223-6780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1868
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: