Provider Demographics
NPI:1053360693
Name:LOWE, ROBERT MICHAEL (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:LOWE
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3017 W CHARLESTON BLVD STE 50
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1987
Mailing Address - Country:US
Mailing Address - Phone:702-686-9239
Mailing Address - Fax:702-995-2124
Practice Address - Street 1:3017 W CHARLESTON BLVD STE 50
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1987
Practice Address - Country:US
Practice Address - Phone:702-686-9239
Practice Address - Fax:702-995-2124
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV166972080P0216X
AL30911208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV16697OtherNEVADA MEDICAL LICENSE
NVV114753Medicare UPIN