Provider Demographics
NPI:1871578138
Name:LOWSTUTER, RICHARD H (DPM)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:H
Last Name:LOWSTUTER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MERCHANT STREET
Mailing Address - Street 2:SUITE 220
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-3740
Mailing Address - Country:US
Mailing Address - Phone:513-533-6507
Mailing Address - Fax:513-645-9767
Practice Address - Street 1:4973 GLENWAY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-3907
Practice Address - Country:US
Practice Address - Phone:513-471-0658
Practice Address - Fax:513-471-0688
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36001712L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0859594Medicaid
OH0859594Medicaid
480024729Medicare PIN
OHLO0429052Medicare PIN
OHT80432Medicare UPIN
OH0429053Medicare PIN
0698420001Medicare NSC