Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 10017 | SC |
N | 207U00000X | Nuclear Medicine Specialist | 10017 | SC |
NPI | 1124082367 |
---|---|
Provider Name | Isom Lowman |
First Address | Greenwood, SC 29649-0001 |
Second Address | Chester, SC 29706-9769 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 24/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10017 | (05) | SC |
10017 | SC MEDICAL LICENSE# (01) | SC |
100170 | (05) | SC |
360002880 | RAILROAD MEDICARE (01) | SC |
AL9404992 | DEA REGISTRATION# (01) | |
B92127 | (02) |