Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 000815 | GA |
NPI | 1023066941 |
---|---|
Provider Name | Mr. Barrie Douglas Lowman |
First Address | Atlanta, GA 30342-1786 |
Second Address | Atlanta, GA 30342-1786 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R74333 | (02) | GA |