Provider Demographics
NPI:1730112392
Name:LOWELL, SETH H (MD)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:H
Last Name:LOWELL
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:DEPT OF SURGERY MSC105610
Mailing Address - Street 2:1 UNIVERSITY OF NEW MEXICO
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-6451
Mailing Address - Fax:505-727-9276
Practice Address - Street 1:2211 LOMAS BLVD NE
Practice Address - Street 2:2ND FLOOR - SURGICAL SPECIALTY CLINICS
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2745
Practice Address - Country:US
Practice Address - Phone:505-272-6451
Practice Address - Fax:505-727-9276
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM9073207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM8292Medicaid
B65513Medicare UPIN