Provider Demographics
NPI:1154508323
Name:MCCOWAN, BRADLEY SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:SCOTT
Last Name:MCCOWAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:55 WHITCHER ST NE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1155
Mailing Address - Country:US
Mailing Address - Phone:770-428-4426
Mailing Address - Fax:770-948-1275
Practice Address - Street 1:55 WHITCHER ST NE
Practice Address - Street 2:SUITE 250
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1155
Practice Address - Country:US
Practice Address - Phone:770-428-4426
Practice Address - Fax:770-948-1275
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2014-03-12
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Provider Licenses
StateLicense IDTaxonomies
GA000849208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology