Basic Information
| Provider Information | |||||||||
| NPI: | 1528051703 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STYER | ||||||||
| FirstName: | LOWELL | ||||||||
| MiddleName: | LAMAR | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2864 ASHMUN ST | ||||||||
| Address2: | |||||||||
| City: | SAULT SAINTE MARIE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 497833740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9066325200 | ||||||||
| FaxNumber: | 9066325276 | ||||||||
| Practice Location | |||||||||
| Address1: | 2864 ASHMUN ST | ||||||||
| Address2: | |||||||||
| City: | SAULT SAINTE MARIE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 497833740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9066325200 | ||||||||
| FaxNumber: | 9066325276 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2005 | ||||||||
| LastUpdateDate: | 10/11/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MI048380 | MI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1749990 | 05 | MI | MEDICAID | 0807015771 | 01 | MI | BLUE CROSS PROVIDER NUMBE | OTHER | 18 358-1 | 01 | MI | FAA EXAMINER NUMBER | OTHER |