Healthcare Provider Details

I. General information

NPI: 1790362721
Provider Name (Legal Business Name): VICTOR BOWDEN MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 SYCAMORE DR
DECATUR GA
30030-1645
US

IV. Provider business mailing address

1045 SYCAMORE DR
DECATUR GA
30030-1645
US

V. Phone/Fax

Practice location:
  • Phone: 404-254-0961
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number95999
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number95999
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: