1174933907 NPI number — DELAWARE SPINE CENTER

Table of content: DR. ROBERT RAY LOWE JR. MD (NPI 1366592248)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174933907 NPI number — DELAWARE SPINE CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DELAWARE SPINE CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1174933907
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/01/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1517
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEAR
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19701-7517
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-287-9914
Provider Business Mailing Address Fax Number:
866-347-3120

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 BECKS WOODS DR
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
BEAR
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19701-3854
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-287-9914
Provider Business Practice Location Address Fax Number:
866-347-3120
Provider Enumeration Date:
05/01/2014

Additional Information

Authorized Official

Authorized Official Last Name:
LEITZKE
Authorized Official First Name:
ANDREW
Authorized Official Middle Name:
MARK
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
302-287-9914

Provider Taxonomy Codes

  • Taxonomy code: 208VP0014X , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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