Provider Demographics
NPI:1801835400
Name:CHAMBERS, LOWELL W (MD)
Entity Type:Individual
Prefix:DR
First Name:LOWELL
Middle Name:W
Last Name:CHAMBERS
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 1:6075 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-5131
Mailing Address - Country:US
Mailing Address - Phone:614-864-6363
Mailing Address - Fax:614-864-2248
Practice Address - Street 1:6075 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-5131
Practice Address - Country:US
Practice Address - Phone:614-864-6363
Practice Address - Fax:614-864-2248
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35073587208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2609636Medicaid
OH1703438OtherUHC PROVIDER NUMBER
OH000000383158OtherBC/BS PROVIDER NUMBER
OH7067789OtherAETNA PROVIDER NUMBER
OH000000383158OtherBC/BS PROVIDER NUMBER
OHI39037Medicare UPIN
CH4167071Medicare PIN