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Individual

LOWELL D CARPENTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
36065455
IL
207RI0011X
Interventional Cardiology Physician
Primary
036-065455
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036065455
IL
01
36065455
LICENSE
01
P00958
INDIVIDUAL MEDICARE #
Enumeration date
07/13/2006
Last updated
06/09/2015
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