Provider Demographics
NPI:1225037484
Name:BOWLES, MARY ALLISON (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ALLISON
Last Name:BOWLES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6161 KEMPSVILLE CIR
Mailing Address - Street 2:SUITE 315
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3932
Mailing Address - Country:US
Mailing Address - Phone:757-461-5400
Mailing Address - Fax:757-461-3305
Practice Address - Street 1:6161 KEMPSVILLE CIR
Practice Address - Street 2:SUITE 315
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3932
Practice Address - Country:US
Practice Address - Phone:757-461-5400
Practice Address - Fax:757-461-3305
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2007-10-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01012311912084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAH37580Medicare UPIN