Provider Demographics
NPI:1063894418
Name:LOWLEY, MICHAEL STEVEN (MBBS BSC (HONS))
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:STEVEN
Last Name:LOWLEY
Suffix:
Gender:M
Credentials:MBBS BSC (HONS)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 HIGHLAND AVE NE
Mailing Address - Street 2:2417
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1478
Mailing Address - Country:US
Mailing Address - Phone:404-263-5339
Mailing Address - Fax:
Practice Address - Street 1:1440 CLIFTON RD NE
Practice Address - Street 2:EMORY SCHOOL OF MEDICINE
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1053
Practice Address - Country:US
Practice Address - Phone:404-727-3316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-22
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA808812084P0800X
ZZ7088454390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry