Provider Demographics
NPI:1861425712
Name:LOWENSTEIN, BENJAMIN A (MD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:A
Last Name:LOWENSTEIN
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 1:121 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 3100
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2653
Mailing Address - Country:US
Mailing Address - Phone:207-729-7939
Mailing Address - Fax:207-725-4717
Practice Address - Street 1:121 MEDICAL CENTER DRIVE
Practice Address - Street 2:SUITE 3100
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011
Practice Address - Country:US
Practice Address - Phone:207-729-7939
Practice Address - Fax:207-725-4717
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME015610207RC0000X
NH12201207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME410040099Medicaid
ME41004099Medicaid
H66555Medicare UPIN
ME410040099Medicaid
ME410040099Medicaid
MEMM9518Medicare PIN