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General NPI Number Information
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NPI Number | 1134222672
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Entity Type | Individual
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Provider Name | SUSAN LOVELLE-ALLEN MD
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Gender | Female
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 03/29/2025
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Provider Practice Location Address
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Address Line | 7718 SIX FORKS RD STE 106
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City | RALEIGH
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State | NC
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Zip | 27615-5072
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Country | US
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Telephone | 919-925-5910
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Fax | 919-704-7535
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Provider Business Mailing Address
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Address Line | 2024 BIRDHOUSE LN
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City | WAKE FOREST
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State | NC
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Zip | 27587-8212
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Country | US
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Telephone | 919-925-5910
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Fax | 919-704-7535
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number | 200201488
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 200201488
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License Number State | NC
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