Provider Demographics
NPI:1437108305
Name:BHOWMICK, SAMAR K (MD)
Entity Type:Individual
Prefix:
First Name:SAMAR
Middle Name:K
Last Name:BHOWMICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40480
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36640-0480
Mailing Address - Country:US
Mailing Address - Phone:251-410-5437
Mailing Address - Fax:251-434-3852
Practice Address - Street 1:1610 CENTER ST
Practice Address - Street 2:SUITE 1S
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1512
Practice Address - Country:US
Practice Address - Phone:251-410-5437
Practice Address - Fax:251-434-3852
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL77572080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1428604Medicaid
FL259905800Medicaid
AL51098154OtherBCBS CENTER ST
AL009927370Medicaid
AL33-10000OtherUNITED HEALTHCARE
AL51098155OtherBCBS SPRINGHILL
MS00122158Medicaid
LA1428604Medicaid
LA1428604Medicaid
MS00122158Medicaid