Provider Demographics
NPI:1093090599
Name:BOWLING, CARLIE ROBERT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CARLIE
Middle Name:ROBERT
Last Name:BOWLING
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4619 MURCHISON RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-2303
Mailing Address - Country:US
Mailing Address - Phone:910-964-5357
Mailing Address - Fax:
Practice Address - Street 1:4619 MURCHISON RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-2303
Practice Address - Country:US
Practice Address - Phone:910-964-5357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-15
Last Update Date:2011-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14736183500000X
TN22988183500000X
SC9798183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist