Provider Demographics
NPI:1003850439
Name:BOWSER, CORINNA SABINE (MD)
Entity Type:Individual
Prefix:DR
First Name:CORINNA
Middle Name:SABINE
Last Name:BOWSER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MERION AVE
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-2417
Mailing Address - Country:US
Mailing Address - Phone:484-270-8584
Mailing Address - Fax:484-270-8799
Practice Address - Street 1:200 MERION AVE
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-2417
Practice Address - Country:US
Practice Address - Phone:484-270-8584
Practice Address - Fax:484-270-8799
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD428476207K00000X
PAMD 4284762080P0201X
NJ25MA08725000207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1016941410001Medicaid
PA1016941410001Medicaid