Healthcare Provider Details

I. General information

NPI: 1336636083
Provider Name (Legal Business Name): SHANIQUE ALECIA CHANTELLE STERLING LOVY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2018
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date: 11/28/2018
Reactivation Date: 02/01/2019

III. Provider practice location address

1000 E BROAD ST
RICHMOND VA
23219-1930
US

IV. Provider business mailing address

1000 E BROAD ST
RICHMOND VA
23219-1930
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-5372
  • Fax: 804-828-5858
Mailing address:
  • Phone: 804-828-2467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number0101284995
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: