MEDICARE: DR. ALVIN COWANS DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	POD001279	GA

General Provider Information

NPI Number	:	1164812202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALVIN COWANS DPM

Provider Business Mailing Address
First Line	:	5077 DALLAS HWY STE 311
Second Line	:
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127-4510
Country	:	US
Telephone Number	:	770-727-0614
Fax Number	:	770-799-8453

Provider Business Practice Location Address
First Line	:	5077 DALLAS HWY STE 311
Second Line	:
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127-4510
Country	:	US
Telephone Number	:	770-727-0614
Fax Number	:	770-799-8453

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2015
Last Update Date	:	12/02/2021

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