Provider Demographics
NPI:1174515456
Name:LOWY, ANDREW E (DPM)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:E
Last Name:LOWY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14001 N 7TH ST STE A101
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-4382
Mailing Address - Country:US
Mailing Address - Phone:602-942-3966
Mailing Address - Fax:602-548-9470
Practice Address - Street 1:10214 N TATUM BLVD STE B300
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-4233
Practice Address - Country:US
Practice Address - Phone:602-954-0777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPOD-000220213ES0103X
AZ0220213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0194250OtherBCBS
AZ700387Medicaid
AZ73298Medicare ID - Type Unspecified
AZ700387Medicaid