Provider Demographics
NPI:1679534747
Name:LOWE, DAVID (IDC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:LOWE
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USNH
Mailing Address - Street 2:BOX 55
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09589
Mailing Address - Country:US
Mailing Address - Phone:0115-399-7745
Mailing Address - Fax:
Practice Address - Street 1:USNH
Practice Address - Street 2:BOX 55
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09589
Practice Address - Country:US
Practice Address - Phone:0115-399-7745
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman