MEDICARE: LOWELL D. MEYERSON DO, PC

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	208C00000X	Colon & Rectal Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0053408000	OTHER	PA	KEYSTONE HEALTH PLAN EAST
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558699504
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOWELL D. MEYERSON DO, PC

Provider Business Mailing Address
First Line	:	50 TOWNSHIP LINE RD
Second Line	:	SUITE G02
City	:	ELKINS PARK
State	:	PA
Zip	:	19027-2249
Country	:	US
Telephone Number	:	215-379-0444
Fax Number	:	215-663-1359

Provider Business Practice Location Address
First Line	:	50 TOWNSHIP LINE RD
Second Line	:	SUITE G02
City	:	ELKINS PARK
State	:	PA
Zip	:	19027-2249
Country	:	US
Telephone Number	:	215-379-0444
Fax Number	:	215-663-1359

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. JOYCE D OWENS
Credential	:
Telephone Number	:	215-379-0710

Provider Enumeration Date	:	12/03/2009
Last Update Date	:	08/05/2014

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