Provider Demographics
NPI:1255966735
Name:LOWERY, DAVID LEE (RPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:LEE
Last Name:LOWERY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 MIDVALE AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-5522
Mailing Address - Country:US
Mailing Address - Phone:240-344-3105
Mailing Address - Fax:
Practice Address - Street 1:1102 MIDVALE AVE
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-5522
Practice Address - Country:US
Practice Address - Phone:240-344-3105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD102901835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1962430942Medicaid