MEDICARE: PETER COWEN MD

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
1	207R00000X	Internal Medicine Physician	ME40015	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598707200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER COWEN MD

Provider Business Mailing Address
First Line	:	5700 LAKE WORTH RD
Second Line	:	MEDICAL SPECIALISTS OF THE PALM BEACHES #204
City	:	LAKE WORTH
State	:	FL
Zip	:	33463
Country	:	US
Telephone Number	:	561-968-7968
Fax Number	:	561-964-4603

Provider Business Practice Location Address
First Line	:	5401 S CONGRESS AVE
Second Line	:	212 MEDICAL SPECIALISTS OF THE PALM BEACHES
City	:	ATLANTIS
State	:	FL
Zip	:	33462-6635
Country	:	US
Telephone Number	:	561-357-2040
Fax Number	:	561-357-2045

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	04/11/2016

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Directions to “ PETER COWEN MD” Practice Location

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