Provider Demographics
NPI:1235481755
Name:BOWE, DEDRICK K (MD)
Entity Type:Individual
Prefix:
First Name:DEDRICK
Middle Name:K
Last Name:BOWE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6920 POINTE INVERNESS WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-7934
Mailing Address - Country:US
Mailing Address - Phone:260-479-3514
Mailing Address - Fax:260-479-3520
Practice Address - Street 1:800 BROADWAY STE 315
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46802-2149
Practice Address - Country:US
Practice Address - Phone:260-425-3782
Practice Address - Fax:260-425-3783
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2022-06-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01079699A207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine