Healthcare Provider Details

I. General information

NPI: 1548436884
Provider Name (Legal Business Name): STEVEN RICHARD BOWERS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2008
Last Update Date: 01/22/2024
Certification Date: 01/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1431 NURSERY ST STE 101B
FOGELSVILLE PA
18051-1612
US

IV. Provider business mailing address

701 OSTRUM ST SUITE 202
FOUNTAIN HILL PA
18015-1155
US

V. Phone/Fax

Practice location:
  • Phone: 610-336-8260
  • Fax:
Mailing address:
  • Phone: 484-526-2200
  • Fax: 484-526-2398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOT012039
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS015481
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License NumberOS015481
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC7-0004010
License Number StateDE
# 5
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS015481
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: