Lowery, Wylie D.

Lowery, Wylie D. is an individual health care provider with primary practice located at 14605 Potomac Branch Dr Ste 300 , Woodbridge VA 22191-3337. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Lowery, Wylie D. can be contacted via phone (703) 490-1112.

Contact Information

Primary practice address
14605 Potomac Branch Dr Ste 300 Woodbridge VA 22191-3337
Phone: (703) 490-1112
Fax: (703) 878-8735
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 0101049758 Virginia

Profile Details

NPI number 1518931948
LBN Legal business name Lowery, Wylie D.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2006
Last updated Sep 20th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518931948 NPPES
Virginia MEDICAID 6400973

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