Healthcare Provider Details

I. General information

NPI: 1467474049
Provider Name (Legal Business Name): RAJENDRA LOWTAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 E MAIN ST STE 215-217
WESTMINSTER MD
21157-5037
US

IV. Provider business mailing address

420 CHINQUAPIN ROUND RD STE 2K&2L
ANNAPOLIS MD
21401-4006
US

V. Phone/Fax

Practice location:
  • Phone: 410-940-3254
  • Fax: 410-531-2972
Mailing address:
  • Phone: 410-990-1811
  • Fax: 410-531-2972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0058483
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: