Healthcare Provider Details

I. General information

NPI: 1922027846
Provider Name (Legal Business Name): BERNARD L. MCGOWAN, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

297 UNION AVE
FRAMINGHAM MA
01702-6337
US

IV. Provider business mailing address

297 UNION AVE
FRAMINGHAM MA
01702-6337
US

V. Phone/Fax

Practice location:
  • Phone: 508-872-4590
  • Fax: 508-872-0038
Mailing address:
  • Phone: 508-872-4590
  • Fax: 508-872-0038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number28621
License Number StateMA

VIII. Authorized Official

Name: DR. BERNARD L. MCGOWAN
Title or Position: DIRECTOR
Credential: M.D.
Phone: 508-872-4590