MEDICARE: DR. MICHAEL W LOWHORN DPM

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	213E00000X	Podiatrist	00501	MO
2	213ES0103X	Foot & Ankle Surgery Podiatrist	00501	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396745220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL W LOWHORN DPM

Provider Business Mailing Address
First Line	:	3009 N BALLAS RD
Second Line	:	SUITE 100 B
City	:	SAINT LOUIS
State	:	MO
Zip	:	63131-2322
Country	:	US
Telephone Number	:	314-983-4034
Fax Number	:	314-432-3629

Provider Business Practice Location Address
First Line	:	3009 N BALLAS RD
Second Line	:	SUITE 100 B
City	:	SAINT LOUIS
State	:	MO
Zip	:	63131-2322
Country	:	US
Telephone Number	:	314-983-4034
Fax Number	:	314-432-3629

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	01/08/2014

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