Provider Demographics
NPI:1326334368
Name:OWENS, GARY MITCHELL (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:MITCHELL
Last Name:OWENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5 PALMER DR
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1289
Mailing Address - Country:US
Mailing Address - Phone:610-558-1799
Mailing Address - Fax:610-558-4558
Practice Address - Street 1:5 PALMER DR
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1289
Practice Address - Country:US
Practice Address - Phone:610-558-1799
Practice Address - Fax:610-558-4558
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD018837E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine