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1407290398

NPI Code Detail

MEDICARE: DR. GLENDA JEANNETTE BOWEN M.D.

MEDICARE: DR. GLENDA JEANNETTE BOWEN M.D.

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	207R00000X	Internal Medicine Physician	054662	CT
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	287531	MA
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	054662	CT
4	207RP1001X	Pulmonary Disease Physician	054662	CT
5	207RS0012X	Sleep Medicine (Internal Medicine) Physician	287531	MA
6	208M00000X	Hospitalist Physician	054662	CT
7	207RP1001X	Pulmonary Disease Physician	287531	MA

General Provider Information

NPI Number	:	1407290398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GLENDA JEANNETTE BOWEN M.D.

Provider Business Mailing Address
First Line	:	725 NORTH ST
Second Line	:
City	:	PITTSFIELD
State	:	MA
Zip	:	01201-4124
Country	:	US
Telephone Number	:	413-447-2695
Fax Number	:	413-447-3111

Provider Business Practice Location Address
First Line	:	725 NORTH ST
Second Line	:
City	:	PITTSFIELD
State	:	MA
Zip	:	01201-4124
Country	:	US
Telephone Number	:	413-447-2695
Fax Number	:	413-447-3111

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

Provider Enumeration Date	:	04/22/2013
Last Update Date	:	07/19/2021

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Directions to “ DR. GLENDA JEANNETTE BOWEN M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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