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NPI Code Detail

MEDICARE: GLEN DAVID LOWERY D.O.

MEDICARE: GLEN DAVID LOWERY D.O.
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
1208600000XSurgery PhysicianOS4038FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942204326
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLEN DAVID LOWERY D.O.
Provider Business Mailing Address
First Line : 2039 INDIAN ROCKS RD S
Second Line :
City : LARGO
State : FL
Zip : 33774-1035
Country : US
Telephone Number : 727-584-7666
Fax Number : 727-586-1386
Provider Business Practice Location Address
First Line : 2039 INDIAN ROCKS RD S
Second Line :
City : LARGO
State : FL
Zip : 33774-1035
Country : US
Telephone Number : 727-584-7666
Fax Number : 727-586-1386
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 07/07/2009

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