Basic Information
| Provider Information | |||||||||
| NPI: | 1801226139 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOWE | ||||||||
| FirstName: | TAMMY | ||||||||
| MiddleName: | LEA | ||||||||
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| Credential: | CSA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1175 COOK RD STE 230 | ||||||||
| Address2: | RMC PALMETTO SURGICAL GROUP/MEDICAL ARTS CENTER | ||||||||
| City: | ORANGEBURG | ||||||||
| State: | SC | ||||||||
| PostalCode: | 291188201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8033953900 | ||||||||
| FaxNumber: | 8033953920 | ||||||||
| Practice Location | |||||||||
| Address1: | 1175 COOK RD STE 230 | ||||||||
| Address2: | RMC PALMETTO SURGICAL GROUP/MEDICAL ARTS CENTER | ||||||||
| City: | ORANGEBURG | ||||||||
| State: | SC | ||||||||
| PostalCode: | 291188201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8033953900 | ||||||||
| FaxNumber: | 8033953920 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2013 | ||||||||
| LastUpdateDate: | 11/22/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246ZC0007X | 2528 | OH | Y | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Other | Certified First Assistant |
No ID Information.