Provider Demographics
NPI:1144535295
Name:LOWE, MICHAEL (PD)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:LOWE
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3441 GENTILLY BLVD.
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-4933
Mailing Address - Country:US
Mailing Address - Phone:504-304-2249
Mailing Address - Fax:504-304-3791
Practice Address - Street 1:3100 GENTILLY BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-3854
Practice Address - Country:US
Practice Address - Phone:504-940-1480
Practice Address - Fax:504-940-1497
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11336183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist