MEDICARE: LIA H LOWRIE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0203X	Pediatric Critical Care Medicine Physician	2011006601	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
12	P00618511	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	647553	OTHER	OH	AETNA
2	000000221165	OTHER	OH	UNISON
3	727503	OTHER	OH	BUCKEYE
4	000000526045	OTHER	OH	ANTHEM
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	0791237	OTHER	OH	BCMH
9	363783	OTHER	OH	WELLCARE
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154312726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIA H LOWRIE MD

Provider Business Mailing Address
First Line	:	1465 S GRAND BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63104-1003
Country	:	US
Telephone Number	:	314-577-5395
Fax Number	:	314-268-6459

Provider Business Practice Location Address
First Line	:	1465 S GRAND BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63104-1003
Country	:	US
Telephone Number	:	314-577-5395
Fax Number	:	314-268-6459

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	01/15/2021

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Directions to “ LIA H LOWRIE MD” Practice Location

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