1043875008 NPI number — DR. BOBBI-JO ELISABETH LOWIE M.D.

Table of content: DR. BOBBI-JO ELISABETH LOWIE M.D. (NPI 1043875008)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043875008 NPI number — DR. BOBBI-JO ELISABETH LOWIE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOWIE
Provider First Name:
BOBBI-JO
Provider Middle Name:
ELISABETH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043875008
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/02/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
12/16/2019
NPI Reactivation Date:
01/02/2020

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 E REDWOOD ST PH 10
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21202-1394
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
347-502-0839
Provider Business Mailing Address Fax Number:
410-328-8028

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 S PACA STREET
Provider Second Line Business Practice Location Address:
6TH FLOOR SUITE 200
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
667-214-2208
Provider Business Practice Location Address Fax Number:
410-328-8028
Provider Enumeration Date:
05/06/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  D0096962 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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