Healthcare Provider Details

I. General information

NPI: 1578564985
Provider Name (Legal Business Name): LOWRY C SHROPSHIRE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NNMC / PEDIATRICS 8901 WISCONSIN AVE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

5718 GLAMIS DR
ALEXANDRIA VA
22315-4153
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-4917
  • Fax: 301-295-5069
Mailing address:
  • Phone: 703-971-2341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0008X
TaxonomyPediatric Neurodevelopmental Disabilities Physician
License Number0101030250
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: