Provider Demographics
NPI:1598705089
Name:LOWENBERGH, LAURA LEE (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEE
Last Name:LOWENBERGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 OLD BREVARD RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-0012
Mailing Address - Country:US
Mailing Address - Phone:828-697-9765
Mailing Address - Fax:828-697-9766
Practice Address - Street 1:34 OLD BREVARD RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-0012
Practice Address - Country:US
Practice Address - Phone:828-697-9765
Practice Address - Fax:828-697-9766
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC165242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1598705089OtherNPI
NC8953096Medicaid
NCC85574OtherUPIN