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NPI Code Detail

MEDICARE: DR. GEORGE STEPHEN BOWEN M.D.

MEDICARE: DR. GEORGE STEPHEN 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
12083P0901XPublic Health & General Preventive Medicine PhysicianPHC21FL

General Provider Information

NPI Number : 1598023236
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE STEPHEN BOWEN M.D.
Provider Business Mailing Address
First Line : 780 SW 24TH STREET
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33315-2643
Country : US
Telephone Number : 954-467-4700
Fax Number : 954-467-4704
Provider Business Practice Location Address
First Line : 2421 SW 6TH AVENUE
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33315-2613
Country : US
Telephone Number : 954-467-4700
Fax Number : 954-467-4704
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2012
Last Update Date : 05/01/2012

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