Provider Demographics
NPI:1437259371
Name:WITKIEWICZ-BOWSER, JOYCE (DO)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:WITKIEWICZ-BOWSER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1482 BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:16262-9601
Mailing Address - Country:US
Mailing Address - Phone:724-297-3424
Mailing Address - Fax:724-297-5425
Practice Address - Street 1:1482 BUTLER RD
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:PA
Practice Address - Zip Code:16262-9601
Practice Address - Country:US
Practice Address - Phone:724-297-3424
Practice Address - Fax:724-297-5425
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008721L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
11013039OtherCAQH
PA192936OtherBLUE SHIELD
PA251759OtherUPMC
PAP001158OtherGATEWAY
PA1189587OtherFIRST HEALTH/COVENTRY
PA196726OtherUNISON
PA196726OtherUNISON
PA16269440001Medicaid