Healthcare Provider Details

I. General information

NPI: 1659727261
Provider Name (Legal Business Name): PAUL BOWARY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2016
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 CENTERVILLE RD STE 105A
WARWICK RI
02886-4367
US

IV. Provider business mailing address

501 CENTERVILLE RD STE 105A
WARWICK RI
02886-4367
US

V. Phone/Fax

Practice location:
  • Phone: 401-300-0134
  • Fax: 401-362-8222
Mailing address:
  • Phone: 401-300-0134
  • Fax: 401-362-8222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberLP03589
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD17092
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: