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NPI Code Detail

MEDICARE: SAMUEL GOWAN PA-C

MEDICARE:   SAMUEL  GOWAN  PA-C
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1437014362
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL GOWAN PA-C
Provider Business Mailing Address
First Line : 2945 HAZELWOOD ST STE 200
Second Line :
City : MAPLEWOOD
State : MN
Zip : 55109-1243
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2945 HAZELWOOD ST STE 200
Second Line :
City : MAPLEWOOD
State : MN
Zip : 55109-1243
Country : US
Telephone Number : 651-232-7800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2025
Last Update Date : 01/29/2026

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Directions to “ SAMUEL GOWAN PA-C” Practice Location

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