Provider Demographics
NPI:1730210774
Name:LOW, ROBERT L (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:LOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BOB
Other - Middle Name:L
Other - Last Name:LOW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:303-724-4307
Mailing Address - Fax:303-724-1105
Practice Address - Street 1:12605 E 16TH AVE
Practice Address - Street 2:MAIL STOP B216
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2545
Practice Address - Country:US
Practice Address - Phone:303-724-4307
Practice Address - Fax:303-724-3705
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0029035207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01290352Medicaid
CO01290352Medicaid