Basic Information
Provider Information
NPI: 1790884112
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOW
FirstName: VINCENT
MiddleName: HOCK SENG
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 420 DELAWARE STREET SE
Address2: UNIVERSITY OF MINNESOTA PHYSICIANS, MMC 292
City: MINNEAPOLIS
State: MN
PostalCode: 55455
CountryCode: US
TelephoneNumber: 6122736004
FaxNumber: 6122738459
Practice Location
Address1: 500 HARVARD ST SE
Address2: UNIT J2-300
City: MINNEAPOLIS
State: MN
PostalCode: 554550363
CountryCode: US
TelephoneNumber: 6122736004
FaxNumber: 6122738459
Other Information
ProviderEnumerationDate: 09/22/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X7012NCY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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