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NPI Code Detail

MEDICARE: PHILIP KOWASH M.D.

MEDICARE:   PHILIP  KOWASH  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician014701ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2610109401OTHERMECIGNA
3027424OTHERMEANTHEM
42168755OTHERMEAETNA
5MN0057OTHERMEHARVARD PILGRIM

General Provider Information

NPI Number : 1215991773
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILIP KOWASH M.D.
Provider Business Mailing Address
First Line : 9 HEALTHCARE DRIVE
Second Line : SUITE 201
City : BIDDEFORD
State : ME
Zip : 04005-3747
Country : US
Telephone Number : 207-282-9080
Fax Number : 207-282-9180
Provider Business Practice Location Address
First Line : 13 INDUSTRIAL PARK RD
Second Line :
City : SACO
State : ME
Zip : 04072-1804
Country : US
Telephone Number : 207-283-8800
Fax Number : 207-286-9853
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2006
Last Update Date : 01/20/2011

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Directions to “ PHILIP KOWASH M.D.” Practice Location

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