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General NPI Number Information
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NPI Number | 1679384234
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Entity Type | Organization
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Legal Business Name | PATIENTLY
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 570 LONG POINT RD STE 150
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City | MT PLEASANT
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State | SC
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Zip | 29464-7931
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Country | US
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Telephone | 843-480-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 570 LONG POINT RD STE 150
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City | MT PLEASANT
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State | SC
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Zip | 29464-7931
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Country | US
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Telephone | 843-480-2273
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RICHARD BOWEN
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Credential | MD
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Telephone | 843-509-1254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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