Healthcare Provider Details

I. General information

NPI: 1093845703
Provider Name (Legal Business Name): MR. LOWELL R SHOWALTER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: LOWELL R. SHOWALTER B.S.PHARM.

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3415 ELIZABETH LAKE RD
WATERFORD MI
48328-3009
US

IV. Provider business mailing address

6806 WELLESLEY TER
CLARKSTON MI
48346-2768
US

V. Phone/Fax

Practice location:
  • Phone: 248-682-9400
  • Fax:
Mailing address:
  • Phone: 248-623-4950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302032285
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number4401002888
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: