Provider Demographics
NPI:1063493344
Name:BOWERS, COLIN CHARLES (PA-C)
Entity Type:Individual
Prefix:
First Name:COLIN
Middle Name:CHARLES
Last Name:BOWERS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 N CEDAR CREST BLVD STE 411
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2323
Mailing Address - Country:US
Mailing Address - Phone:484-330-1377
Mailing Address - Fax:
Practice Address - Street 1:2775 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7307
Practice Address - Country:US
Practice Address - Phone:610-861-8080
Practice Address - Fax:610-807-0366
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA003219L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1958616OtherHIGHMARK BLUE SHIELD
405197OtherHEALTHAMERICA/HEALTHASSUR
50053199OtherCAPITAL BLUE CROSS
50053199OtherKEYSTONE HEALTH CENTRAL
P00310851OtherRAILROAD MEDICARE
50053199OtherKEYSTONE HEALTH CENTRAL
095899Medicare PIN