Healthcare Provider Details

I. General information

NPI: 1437310158
Provider Name (Legal Business Name): SHELLY STRICKLAND LOWERY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 09/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 LAUCHWOOD DR
LAURINBURG NC
28352-5501
US

IV. Provider business mailing address

PO BOX 602458
CHARLOTTE NC
28260-4808
US

V. Phone/Fax

Practice location:
  • Phone: 910-291-6904
  • Fax: 910-291-6907
Mailing address:
  • Phone: 704-512-4808
  • Fax: 704-512-4838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberLL31097
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2011-00502
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: