Provider Demographics
NPI:1962570531
Name:LOVE, EDWARD WILLIS JR (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:WILLIS
Last Name:LOVE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1720 WESTCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7285
Mailing Address - Country:US
Mailing Address - Phone:336-883-2500
Mailing Address - Fax:336-883-0902
Practice Address - Street 1:320 BOULEVARD ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-3802
Practice Address - Country:US
Practice Address - Phone:336-878-6226
Practice Address - Fax:336-878-6272
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2008-006322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry