Provider Demographics
NPI:1376539858
Name:BOWER, DOUGLAS J (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:J
Last Name:BOWER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-6120
Mailing Address - Fax:717-409-6223
Practice Address - Street 1:220 WILSON ST
Practice Address - Street 2:STE 109
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-3697
Practice Address - Country:US
Practice Address - Phone:717-851-6120
Practice Address - Fax:717-409-6223
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD049317L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014085240001Medicaid
PA0014085240001Medicaid
PAB0731484Medicare ID - Type Unspecified