Provider Demographics
NPI:1629044722
Name:LOWERY, REBECCA L (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:LOWERY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 SHERMAN ST
Mailing Address - Street 2:STE 510
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-4400
Mailing Address - Country:US
Mailing Address - Phone:303-377-6825
Mailing Address - Fax:303-780-0787
Practice Address - Street 1:455 SHERMAN ST
Practice Address - Street 2:STE 510
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-4400
Practice Address - Country:US
Practice Address - Phone:303-377-6825
Practice Address - Fax:303-780-0787
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO33082207L00000X, 207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026287900Medicaid
CO01330828Medicaid
WY113549000Medicaid
G17314Medicare UPIN
110118Medicare ID - Type Unspecified
CO01330828Medicaid