Healthcare Provider Details

I. General information

NPI: 1972126746
Provider Name (Legal Business Name): RONALD CREIGHTON LOWE III DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2020
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10740 DIXIE HWY STE A
DAVISBURG MI
48350-1123
US

IV. Provider business mailing address

10740 DIXIE HWY STE A
DAVISBURG MI
48350-1123
US

V. Phone/Fax

Practice location:
  • Phone: 248-241-6038
  • Fax: 248-241-6071
Mailing address:
  • Phone: 248-241-6038
  • Fax: 248-241-6071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number5901400493
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: