Provider Demographics
NPI:1891889317
Name:LOWRY, SANDRA PANZARELLA (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:PANZARELLA
Last Name:LOWRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 ST MICHAELS DRIVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7621
Mailing Address - Country:US
Mailing Address - Phone:505-986-8620
Mailing Address - Fax:505-820-2461
Practice Address - Street 1:455 ST MICHAELS DRIVE
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7621
Practice Address - Country:US
Practice Address - Phone:505-986-8620
Practice Address - Fax:505-820-2461
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM87-330207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00NM002188OtherBLUE CROSS & BLUE SHIELD
NM00E1915Medicaid
F20643Medicare UPIN