MEDICARE: GILLIAN KAYE LOWE M.D.

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	207Q00000X	Family Medicine Physician	0116022584	VA
2	207Q00000X	Family Medicine Physician	D75974	MD

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
2	K6430006	OTHER	MD	BCBS

General Provider Information

NPI Number	:	1841510161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GILLIAN KAYE LOWE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 12622
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-4017
Country	:	US
Telephone Number	:	443-481-6480
Fax Number	:	443-481-6515

Provider Business Practice Location Address
First Line	:	3169 BRAVERTON ST
Second Line	:	SUITE 201
City	:	EDGEWATER
State	:	MD
Zip	:	21037-2679
Country	:	US
Telephone Number	:	410-956-4911
Fax Number	:	410-956-4939

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

Provider Enumeration Date	:	06/09/2010
Last Update Date	:	04/01/2015

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