Healthcare Provider Details

I. General information

NPI: 1487657102
Provider Name (Legal Business Name): CHRISTOPHER A BOWENS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 10/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 GLASGOW AVE SUITE 108
NEWARK DE
19702
US

IV. Provider business mailing address

1400 PEOPLES PLZ STE 111
NEWARK DE
19702-5706
US

V. Phone/Fax

Practice location:
  • Phone: 302-834-3700
  • Fax: 302-834-8330
Mailing address:
  • Phone: 302-834-3700
  • Fax: 302-834-8330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberC10002916
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberC1-0002916
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: