Provider Demographics
NPI:1194221457
Name:BOWDEN, AMANDA C (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:C
Last Name:BOWDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 WINDSOR CIR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-3433
Mailing Address - Country:US
Mailing Address - Phone:205-381-5030
Mailing Address - Fax:
Practice Address - Street 1:513 BROOKWOOD BLVD STE 50
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-7802
Practice Address - Country:US
Practice Address - Phone:205-877-2761
Practice Address - Fax:205-877-2399
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AL42558207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program