Provider Demographics
NPI:1821050634
Name:LOWE, LANCE STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:LANCE
Middle Name:STEVEN
Last Name:LOWE
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 1:4 OKATIE CENTER BLVD S.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OKATIE
Mailing Address - State:SC
Mailing Address - Zip Code:29909-7507
Mailing Address - Country:US
Mailing Address - Phone:843-706-3206
Mailing Address - Fax:843-706-3226
Practice Address - Street 1:4 OKATIE CENTER BLVD S.
Practice Address - Street 2:SUITE 201
Practice Address - City:OKATIE
Practice Address - State:SC
Practice Address - Zip Code:29909-7507
Practice Address - Country:US
Practice Address - Phone:843-706-3206
Practice Address - Fax:843-706-3226
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22385208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC223859Medicaid
SC223859Medicaid