Provider Demographics
NPI:1528051703
Name:STYER, LOWELL LAMAR (MD)
Entity type:Individual
Prefix:DR
First Name:LOWELL
Middle Name:LAMAR
Last Name:STYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2864 ASHMUN ST
Mailing Address - Street 2:
Mailing Address - City:SAULT SAINTE MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783-3740
Mailing Address - Country:US
Mailing Address - Phone:906-632-5200
Mailing Address - Fax:906-632-5276
Practice Address - Street 1:2864 ASHMUN ST
Practice Address - Street 2:
Practice Address - City:SAULT SAINTE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783-3740
Practice Address - Country:US
Practice Address - Phone:906-632-5200
Practice Address - Fax:906-632-5276
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMI048380207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1749990Medicaid
MI0807015771OtherBLUE CROSS PROVIDER NUMBE
MI18 358-1OtherFAA EXAMINER NUMBER
MI080007375Medicare ID - Type UnspecifiedRAILROAD MEDICARE PROVIDE
MIP20340001Medicare ID - Type Unspecified
MI1749990Medicaid