Provider Demographics
NPI:1134143589
Name:BOWERS, WILLIAM DAVID (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DAVID
Last Name:BOWERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 95TH AVE N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-3544
Mailing Address - Country:US
Mailing Address - Phone:727-623-9999
Mailing Address - Fax:727-350-5848
Practice Address - Street 1:4900 95TH AVE N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-3544
Practice Address - Country:US
Practice Address - Phone:727-623-9999
Practice Address - Fax:727-350-5848
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14071208600000X
FLME111932208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GL221YMedicare UPIN
TN3013653Medicare ID - Type Unspecified