Provider Demographics
NPI:1811961451
Name:SHINN, LOWELL JR (MD)
Entity type:Individual
Prefix:
First Name:LOWELL
Middle Name:
Last Name:SHINN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 FARSON ST STE 210
Mailing Address - Street 2:
Mailing Address - City:BELPRE
Mailing Address - State:OH
Mailing Address - Zip Code:45714-1069
Mailing Address - Country:US
Mailing Address - Phone:740-376-5000
Mailing Address - Fax:740-376-5002
Practice Address - Street 1:807 FARSON ST STE 210
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-1069
Practice Address - Country:US
Practice Address - Phone:740-376-5000
Practice Address - Fax:740-376-5002
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.090643207RH0003X
PAMD423749207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100900512Medicaid
PAC87670Medicare UPIN
PA100900512Medicaid