Healthcare Provider Details

I. General information

NPI: 1124042684
Provider Name (Legal Business Name): ROBERT E BOWEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 FOUNDATION WAY SUITE 2400
MARTINSBURG WV
25401-9003
US

IV. Provider business mailing address

2000 FOUNDATION WAY SUITE 2400
MARTINSBURG WV
25401-9003
US

V. Phone/Fax

Practice location:
  • Phone: 304-264-9080
  • Fax: 304-264-9082
Mailing address:
  • Phone: 304-264-9080
  • Fax: 304-264-9082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number12922
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number12922
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: