Healthcare Provider Details

I. General information

NPI: 1871511345
Provider Name (Legal Business Name): RICHARD J BOWER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 12/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PL SUITE A
SAINT LOUIS MO
63110-1002
US

IV. Provider business mailing address

C B 8221 7425 FORSYTH
SAINT LOUIS MO
63105-2161
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-6022
  • Fax: 314-454-2442
Mailing address:
  • Phone: 314-454-6022
  • Fax: 314-454-2442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberR4285
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: