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Organization

LOWELL MEDICAL SPECIALISTS, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY DAWSON (OFFICE MANAGER)
(616) 897-8436
Entity
Organization

Contact information

Practice address
1150 N HUDSON ST, LOWELL, MI 49331-1000
(616) 897-8436
(616) 897-5364
Mailing address
1150 N HUDSON ST, LOWELL, MI 49331-1000
(616) 897-8436
(616) 897-5364

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301050027
MI
207R00000X
Internal Medicine Physician
4301063084
MI
208000000X
Pediatrics Physician
4301050027
MI
208000000X
Pediatrics Physician
4301063084
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0D14849
MEDICARE
MI
05
103062947
MI
05
103088774
MI
01
110089735
MEDICARE RAILROAD
MI
01
110110939
MEDICARE RAILROAD
MI
01
1104119931
BCBSM
MI
01
1104178342
BCBSM
MI
01
110D148490
BCBSM
MI
05
3062947
MI
05
3088774
MI
01
4119931
BCBSM
MI
01
4178342
BCBSM
MI
01
CB8671
MEDICARE RAILROAD
MI
Enumeration date
02/18/2008
Last updated
04/25/2008
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