MEDICARE: DR. CHARLES EDWARD BOWERS 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	174400000X	Specialist	21412	SC
2	207RH0003X	Hematology & Oncology Physician	21412	SC

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	:	1942204334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES EDWARD BOWERS MD

Provider Business Mailing Address
First Line	:	380 SERPENTINE DR
Second Line	:	SUITE 200
City	:	SPARTANBURG
State	:	SC
Zip	:	29303-3066
Country	:	US
Telephone Number	:	864-560-7050
Fax Number	:	864-560-7057

Provider Business Practice Location Address
First Line	:	380 SERPENTINE DR
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29303-3066
Country	:	US
Telephone Number	:	864-560-7050
Fax Number	:	864-560-7057

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	08/06/2010

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