Provider Demographics
NPI:1962400200
Name:LOWNEY, MARK X (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:X
Last Name:LOWNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3744
Mailing Address - Country:US
Mailing Address - Phone:877-577-5476
Mailing Address - Fax:
Practice Address - Street 1:484 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3744
Practice Address - Country:US
Practice Address - Phone:877-577-5476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA77209207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3107779Medicaid
MAJ13658Medicare PIN
MAJ13658Medicare ID - Type Unspecified
MA3107779Medicaid