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NPI Code Detail

MEDICARE: DR. ROGER HARRISON BOWER M.D.

MEDICARE: DR. ROGER HARRISON BOWER 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
1207RE0101XEndocrinology, Diabetes & Metabolism PhysicianME 81229FL

General Provider Information

NPI Number : 1699724807
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROGER HARRISON BOWER M.D.
Provider Business Mailing Address
First Line : 551 NATIONAL HEALTH CARE DR
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32114-1495
Country : US
Telephone Number : 386-323-7541
Fax Number : 386-323-7570
Provider Business Practice Location Address
First Line : 551 NATIONAL HEALTH CARE DR
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32114-1495
Country : US
Telephone Number : 386-323-7541
Fax Number : 386-323-7570
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2006
Last Update Date : 09/21/2010

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1356308852 — DR. DIANNE KOWING O.D.
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1346292885 — MR. PATRICK JOHN OBRIEN LCSW CAP
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DAYTONA BEACH, FL
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1558397935 — MS. NANCY T SOFIAK M.A.
Practice Location Address:
551 NATIONAL HEALTH CARE DR
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32114-1495
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Practice Fax: 386-323-7570

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