Healthcare Provider Details
I. General information
NPI: 1366980807
Provider Name (Legal Business Name): ROBERT M LOWE MD PHD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/04/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3017 W CHARLESTON BLVD STE 50
LAS VEGAS NV
89102-1987
US
IV. Provider business mailing address
3017 W CHARLESTON BLVD STE 50
LAS VEGAS NV
89102-1987
US
V. Phone/Fax
- Phone: 702-686-9239
- Fax: 702-995-2124
- Phone: 702-686-9239
- Fax: 702-995-2124
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0216X |
| Taxonomy | Pediatric Rheumatology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
M
LOWE
Title or Position: PRESIDENT
Credential: MD, PHD
Phone: 702-686-9239