Provider Demographics
NPI:1518932813
Name:LOWERY, WALTER P (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:P
Last Name:LOWERY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:730 THIMBLE SHOALS BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4562
Mailing Address - Country:US
Mailing Address - Phone:757-223-5700
Mailing Address - Fax:757-310-6619
Practice Address - Street 1:730 THIMBLE SHOALS BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4562
Practice Address - Country:US
Practice Address - Phone:757-223-5700
Practice Address - Fax:757-310-6619
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2010-10-29
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Provider Licenses
StateLicense IDTaxonomies
VA0101028682207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005600359Medicaid
VA005600359Medicaid
080001553Medicare ID - Type Unspecified