Provider Demographics
NPI:1366481400
Name:BOWER, CURTIS EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:EDWARD
Last Name:BOWER
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 1:3 RIVERSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4955
Mailing Address - Country:US
Mailing Address - Phone:540-224-5170
Mailing Address - Fax:540-983-8213
Practice Address - Street 1:3 RIVERSIDE CIR
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4955
Practice Address - Country:US
Practice Address - Phone:540-224-5170
Practice Address - Fax:540-983-8213
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101239298208600000X, 208600000X
NC200300008208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00647326OtherMEDICARE RAILROAD
NC5906104Medicaid
NC145X8OtherBCBSNC
NC200300008OtherNC MEDICAL LICENSE
VA010284163Medicaid
VA010471D65Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
NCP00647326OtherMEDICARE RAILROAD
VA010284163Medicaid