Provider Demographics
NPI:1467594853
Name:LOWEN, MARC (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:
Last Name:LOWEN
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 1:25 HOOKS LN
Mailing Address - Street 2:SUITE 212
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-1617
Mailing Address - Country:US
Mailing Address - Phone:410-653-6500
Mailing Address - Fax:410-653-6511
Practice Address - Street 1:25 HOOKS LN
Practice Address - Street 2:SUITE 212
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-1617
Practice Address - Country:US
Practice Address - Phone:410-653-6500
Practice Address - Fax:410-653-6511
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM05394173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD854Medicare ID - Type Unspecified
MDC57373Medicare UPIN