MEDICARE: LOVELACE DOFFOUR

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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1730041559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOVELACE DOFFOUR

Provider Business Mailing Address
First Line	:	3636 CHIPPENDALE CIR
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22193-5354
Country	:	US
Telephone Number	:	571-723-9892
Fax Number	:

Provider Business Practice Location Address
First Line	:	3636 CHIPPENDALE CIR
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22193-5354
Country	:	US
Telephone Number	:	571-723-9892
Fax Number	:

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

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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Directions to “ LOVELACE DOFFOUR ” Practice Location

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