1083730485 NPI number — RAYMOND FRANCIS LOWER D.O.

Table of content: MELINA SALINAS (NPI 1811864903)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083730485 NPI number — RAYMOND FRANCIS LOWER D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOWER
Provider First Name:
RAYMOND
Provider Middle Name:
FRANCIS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
M

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:
1083730485
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/13/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19465 DEERFIELD AVE STE 405
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEESBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20176-1707
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-858-1800
Provider Business Mailing Address Fax Number:
703-858-1801

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19465 DEERFIELD AVE STE 405
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEESBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20176-1707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-858-1800
Provider Business Practice Location Address Fax Number:
703-858-1801
Provider Enumeration Date:
03/21/2007

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: 207XX0004X , with the licence number:  0101242630 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207X00000X , with the licence number: 0102037078 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1113-0001 . This is a "CAP CARE ID#" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4138572 . This is a "AETNA ID#" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 0860461-007 . This is a "CIGNA HMO ID#" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 00741190 . This is a "UNITED HEALTH CARE ID#" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 086034 . This is a "ANTHEM BCBS VA ID#" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 411356 . This is a "OPTIMUM CHOICE ID#" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 52-1839524 . This is a "TAX ID#" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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