Provider Demographics
NPI:1346943628
Name:BOWEN, NATHANIEL BRANDES (DO)
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:BRANDES
Last Name:BOWEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7327 WINDALIERE DR
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-8733
Mailing Address - Country:US
Mailing Address - Phone:704-530-2323
Mailing Address - Fax:
Practice Address - Street 1:3535 FARM LAKE DR SW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-7219
Practice Address - Country:US
Practice Address - Phone:704-403-0463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-24
Last Update Date:2023-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program