Basic Information
Provider Information
NPI: 1760453385
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOWE
FirstName: STEVEN
MiddleName: CRAIG
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 INDEPENDENCE PT STE 212
Address2:  
City: GREENVILLE
State: SC
PostalCode: 296154536
CountryCode: US
TelephoneNumber: 8647976303
FaxNumber:  
Practice Location
Address1: 1210 W FARIS RD
Address2:  
City: GREENVILLE
State: SC
PostalCode: 296054444
CountryCode: US
TelephoneNumber: 8642954410
FaxNumber: 8642953441
Other Information
ProviderEnumerationDate: 01/31/2006
LastUpdateDate: 01/25/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X24006SCY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
T8151405SC MEDICAID
P0082191301SCRAILROAD MEDICAREOTHER


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