Provider Demographics
NPI:1114924602
Name:BOWLES, MARGARET SUSAN (PA)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:SUSAN
Last Name:BOWLES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-8927
Mailing Address - Country:US
Mailing Address - Phone:706-324-4891
Mailing Address - Fax:706-256-2424
Practice Address - Street 1:2000 HAMILTON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-8927
Practice Address - Country:US
Practice Address - Phone:706-324-4891
Practice Address - Fax:706-256-2424
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000037363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA97WCGDRMedicare ID - Type Unspecified
GAQ31942Medicare UPIN