MEDICARE: DR. KELLY R. BOWEN D.O.

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	207V00000X	Obstetrics & Gynecology Physician	273883	MA

General Provider Information

NPI Number	:	1174920557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KELLY R. BOWEN D.O.

Provider Business Mailing Address
First Line	:	9 INDUSTRIAL RD STE 5
Second Line	:
City	:	MILFORD
State	:	MA
Zip	:	01757-3736
Country	:	US
Telephone Number	:	508-473-1480
Fax Number	:	508-473-1210

Provider Business Practice Location Address
First Line	:	100 MEDWAY RD STE 401
Second Line	:
City	:	MILFORD
State	:	MA
Zip	:	01757-2923
Country	:	US
Telephone Number	:	508-634-7338
Fax Number	:	508-634-7315

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

Provider Enumeration Date	:	12/01/2014
Last Update Date	:	10/28/2025

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