Provider Demographics
NPI:1891426433
Name:LOWERRE, MICHAEL (MS RRA RPA RT(R)(VI))
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:LOWERRE
Suffix:
Gender:M
Credentials:MS RRA RPA RT(R)(VI)
Other - Prefix:
Other - First Name:MIKE
Other - Middle Name:
Other - Last Name:LOWERRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS RRA RPA RT R VI
Mailing Address - Street 1:342 NASH STONE CT
Mailing Address - Street 2:
Mailing Address - City:ALVATON
Mailing Address - State:KY
Mailing Address - Zip Code:42122-7806
Mailing Address - Country:US
Mailing Address - Phone:321-458-1549
Mailing Address - Fax:
Practice Address - Street 1:250 PARK ST
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-1760
Practice Address - Country:US
Practice Address - Phone:270-745-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner AssistantGroup - Single Specialty