Healthcare Provider Details

I. General information

NPI: 1841836822
Provider Name (Legal Business Name): SHERRON BOWIE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2019
Last Update Date: 11/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 BEISER BLVD
DOVER DE
19904-5773
US

IV. Provider business mailing address

75 FOXWOOD DR
SMYRNA DE
19977-2207
US

V. Phone/Fax

Practice location:
  • Phone: 302-678-7438
  • Fax:
Mailing address:
  • Phone: 215-432-6202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberLP-0000327
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: