Healthcare Provider Details

I. General information

NPI: 1497703862
Provider Name (Legal Business Name): TIMOTHY JAMES LOW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 06/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7505 OSLER DRIVE SUITE 409
TOWSON MD
21204-7739
US

IV. Provider business mailing address

400 REDLAND COURT SUITE 208
OWINGS MILLS MD
21117-3292
US

V. Phone/Fax

Practice location:
  • Phone: 410-321-5651
  • Fax: 410-583-0134
Mailing address:
  • Phone: 410-494-7920
  • Fax: 410-902-8247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberD0024034
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier037124100
Identifier TypeMEDICAID
Identifier StateDC
Identifier Issuer
# 2
Identifier210991300
Identifier TypeMEDICAID
Identifier StateMD
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: