Provider Demographics
NPI:1184619199
Name:LOWE, STEPHEN J (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:J
Last Name:LOWE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 8500-6335
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-6335
Mailing Address - Country:US
Mailing Address - Phone:215-807-8000
Mailing Address - Fax:267-757-0565
Practice Address - Street 1:111 FLORAL VALE BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5522
Practice Address - Country:US
Practice Address - Phone:267-757-0560
Practice Address - Fax:267-757-0565
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD012722E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA068469OtherHIGHMARK BLUE SHIELD
PA0052346000OtherKEYSTONE IBC
PA8017783OtherAETNA
PA0008130940006Medicaid
PA068469Q0SMedicare PIN
PA0052346000OtherKEYSTONE IBC
PA068469OtherHIGHMARK BLUE SHIELD