1982829941 NPI number — DR. RAYMUNDO AHTERI FORCADA-LOWRIE M.D.

Table of content: DR. RAYMUNDO AHTERI FORCADA-LOWRIE M.D. (NPI 1982829941)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982829941 NPI number — DR. RAYMUNDO AHTERI FORCADA-LOWRIE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FORCADA-LOWRIE
Provider First Name:
RAYMUNDO
Provider Middle Name:
AHTERI
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1982829941
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 33829
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92163-3829
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-450-1123
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4535 DRESSLER RD NW
Provider Second Line Business Practice Location Address:
CLAVERICK 2
Provider Business Practice Location Address City Name:
CANTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44718-2545
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-828-0898
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/16/2007

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: 207P00000X , with the licence number:  MD12946 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: A113070 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: 35.127265 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: 258164-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 10/27/2009 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 001113701 . This is a "RI MEDICARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 04/15/2009 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 939025129 . This is a "UEMF GROUP RI MEDICARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: P00775377 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 08-28-2009 . This is a "BCBSRI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 110084187A , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 08/13/2009 . This is a "NHPRI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: RF75957 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".




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