Provider Demographics
NPI:1902820202
Name:LOWE, CHERYL (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:
Last Name:LOWE
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 1:455 WOODVIEW ROAD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:WEST GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19390
Mailing Address - Country:US
Mailing Address - Phone:610-869-4700
Mailing Address - Fax:610-869-4790
Practice Address - Street 1:455 WOODVIEW ROAD
Practice Address - Street 2:SUITE 220
Practice Address - City:WEST GROVE
Practice Address - State:PA
Practice Address - Zip Code:19390
Practice Address - Country:US
Practice Address - Phone:610-869-4700
Practice Address - Fax:610-869-4790
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-052396-L208000000X
DEC1-0004464208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA600968Medicare ID - Type Unspecified
PAF98273Medicare UPIN
PA001638613Medicare ID - Type Unspecified