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1104820885

NPI Code Detail

MEDICARE: ROBERT A LOVE III MD

MEDICARE: ROBERT A LOVE III MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	35030317L	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104820885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT A LOVE III MD

Provider Business Mailing Address
First Line	:	PO BOX 42417
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45242-0417
Country	:	US
Telephone Number	:	513-965-8041
Fax Number	:	513-965-8091

Provider Business Practice Location Address
First Line	:	3000 MACK RD
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-5335
Country	:	US
Telephone Number	:	513-870-7024
Fax Number	:	513-965-8091

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	02/22/2008

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Directions to “ ROBERT A LOVE III MD” Practice Location

Language	Start Address	Practice Location

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