Healthcare Provider Details

I. General information

NPI: 1174515456
Provider Name (Legal Business Name): ANDREW E LOWY DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 08/19/2022
Certification Date: 08/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10214 N TATUM BLVD STE B300
PHOENIX AZ
85028-4233
US

IV. Provider business mailing address

14001 N 7TH ST STE A101
PHOENIX AZ
85022-4382
US

V. Phone/Fax

Practice location:
  • Phone: 602-954-0777
  • Fax:
Mailing address:
  • Phone: 602-942-3966
  • Fax: 602-548-9470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD-000220
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number0220
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: