Healthcare Provider Details

I. General information

NPI: 1730676669
Provider Name (Legal Business Name): NATHAN BOWERS MD, PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2018
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE MEDICAL CENTER BLVD
WINSTON SALEM NC
27157-0001
US

IV. Provider business mailing address

ONE MEDICAL CENTER BLVD
WINSTON SALEM NC
27157-0001
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-4305
  • Fax: 336-716-7359
Mailing address:
  • Phone: 336-716-4305
  • Fax: 336-716-7359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number68087
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number68087
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: