Healthcare Provider Details

I. General information

NPI: 1487795993
Provider Name (Legal Business Name): DAVID A COWAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 TECHNOLOGY DR SUITE 230 BENBROOK MEDICAL CENTER 1
BUTLER PA
16001-1784
US

IV. Provider business mailing address

102 TECHNOLOGY DR SUITE 230 BENBROOK MEDICAL CENTER 1
BUTLER PA
16001-1784
US

V. Phone/Fax

Practice location:
  • Phone: 877-661-3376
  • Fax:
Mailing address:
  • Phone: 877-661-3376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD037215
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberD67402
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberD0067402
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberMD037215
License Number StateDC
# 5
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD439184
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberMD439184
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: