Basic Information
Provider Information
NPI: 1356604961
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOVEITT
FirstName: ANDREW
MiddleName: P
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 320 EAST MAIN STREET
Address2:  
City: CROSBY
State: MN
PostalCode: 56441
CountryCode: US
TelephoneNumber: 2185467000
FaxNumber: 2185464400
Practice Location
Address1: 320 EAST MAIN STREET
Address2:  
City: CROSBY
State: MN
PostalCode: 56441
CountryCode: US
TelephoneNumber: 2185467000
FaxNumber: 2185464400
Other Information
ProviderEnumerationDate: 06/19/2012
LastUpdateDate: 11/19/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/19/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X61863MNY Allopathic & Osteopathic PhysiciansSurgery 
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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