Provider Demographics
NPI:1083051502
Name:DR MICHAEL J LOWNEY,PC
Entity Type:Organization
Organization Name:DR MICHAEL J LOWNEY,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:LOWNEY
Authorized Official - Suffix:
Authorized Official - Credentials:JD,DO
Authorized Official - Phone:617-325-0365
Mailing Address - Street 1:2081 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02132-3313
Mailing Address - Country:US
Mailing Address - Phone:617-325-0365
Mailing Address - Fax:617-325-0194
Practice Address - Street 1:2081 CENTRE ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02132-3313
Practice Address - Country:US
Practice Address - Phone:617-325-0365
Practice Address - Fax:617-325-0194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-23
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA51365207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAF36446Medicare UPIN