Provider Demographics
NPI:1376658864
Name:LOWE, KEVIN MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:MICHAEL
Last Name:LOWE
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 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7230 ENGLE RD STE 100
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-2234
Practice Address - Country:US
Practice Address - Phone:260-234-5400
Practice Address - Fax:260-234-5435
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01074552A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
2551671OtherPARTNERS PHYSICIAN GROUP MEDICAID GROUP NUMBER
OH3010904OtherACUTE CARE SURGERY SERVICE AT AKRON GENERAL MEDICAID #
IN300069685Medicaid
OH3156776Medicaid
OH9338635OtherPARTNERS PHYSICIAN GROUP MEDICARE GROUP NUMBER
OH9382831OtherACUTE CARE SURGERY SERVICE AT AKRON GENERAL MEDICARE #
OHH008171OtherACUTE CARE SURGERY SERVICE INDIVIDUAL MEDICARE #
ININ4866029OtherMEDICARE PTAN
OH1376779702OtherACUTE CARE SURGERY SERVICE AT AKRON GENERAL TYPE 2 NPI #
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI NUMBER