Basic Information
| Provider Information | |||||||||
| NPI: | 1346310489 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOVENVIRTH | ||||||||
| FirstName: | WENDI | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2727 PACES FERRY ROAD | ||||||||
| Address2: | SUITE 1-1100 (ATTENTION DENISE) | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303396150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4702713421 | ||||||||
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| Practice Location | |||||||||
| Address1: | 275 8TH AVE | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100111611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124630104 | ||||||||
| FaxNumber: | 2124630952 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2006 | ||||||||
| LastUpdateDate: | 06/14/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0300X | 227863 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | 207RG0300X | 078675 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
No ID Information.