Healthcare Provider Details

I. General information

NPI: 1619908126
Provider Name (Legal Business Name): JEFFREY A LOWELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 K ST NW #700
WASHINGTON DC
20037-1898
US

IV. Provider business mailing address

2131 K ST NW #700
WASHINGTON DC
20037-1898
US

V. Phone/Fax

Practice location:
  • Phone: 202-715-4225
  • Fax: 202-775-1599
Mailing address:
  • Phone: 202-715-4225
  • Fax: 202-775-1599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number105476
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number105476
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number105476
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number105476
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: