Provider Demographics
NPI:1235157835
Name:BOWEN, HENRY ALBERT (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:ALBERT
Last Name:BOWEN
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 1:7301 FOREST AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3792
Mailing Address - Country:US
Mailing Address - Phone:804-285-4121
Mailing Address - Fax:804-285-4123
Practice Address - Street 1:7301 FOREST AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3792
Practice Address - Country:US
Practice Address - Phone:804-285-4121
Practice Address - Fax:804-285-4123
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010376302084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7135475Medicaid
VA7135475Medicaid