Healthcare Provider Details

I. General information

NPI: 1477697068
Provider Name (Legal Business Name): WILLIAM ADAM GOWER MD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 05/10/2021
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 CENTRAL DR
SANFORD NC
27330-4159
US

IV. Provider business mailing address

333 SOUTH COLUMBIA STREET 450 MACNIDER CB# 7217
CHAPEL HILL NC
27599-0344
US

V. Phone/Fax

Practice location:
  • Phone: 919-718-9512
  • Fax: 919-718-9516
Mailing address:
  • Phone: 919-966-9675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberP17108 (UMP #)
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number2010-01215
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: