Healthcare Provider Details
I. General information
NPI: 1740496991
Provider Name (Legal Business Name): GEOFFREY D. BOWERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/15/2007
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2301 E EVESHAM RD STE 110A
VOORHEES NJ
08043-4501
US
IV. Provider business mailing address
301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US
V. Phone/Fax
- Phone: 856-325-4200
- Fax:
- Phone: 856-355-0340
- Fax: 856-355-0330
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | MD437417 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | MT186317 |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | MA09348100 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: