Healthcare Provider Details
I. General information
NPI: 1992574750
Provider Name (Legal Business Name): CHARLES A BOWDEN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/21/2023
Last Update Date: 12/21/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
801 EASTERN SHORE DR
SALISBURY MD
21804-5934
US
IV. Provider business mailing address
801 EASTERN SHORE DR
SALISBURY MD
21804-5934
US
V. Phone/Fax
- Phone: 410-548-2225
- Fax: 410-548-9542
- Phone: 410-548-2225
- Fax: 410-548-9542
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | SO4203 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: