Healthcare Provider Details

I. General information

NPI: 1104230283
Provider Name (Legal Business Name): MICHAEL WES LOVE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 12/03/2021
Certification Date: 12/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 VERDAE BLVD STE 202
GREENVILLE SC
29607-4098
US

IV. Provider business mailing address

300 E MCBEE AVE
GREENVILLE SC
29601-2842
US

V. Phone/Fax

Practice location:
  • Phone: 864-522-2100
  • Fax: 864-522-2105
Mailing address:
  • Phone: 864-522-8603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VB0002X
TaxonomyObesity Medicine (Obstetrics & Gynecology) Physician
License Number37183
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number411168
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number37183
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: