Provider Demographics
NPI:1437399326
Name:MCGOWEN, CHARLES HAMMOND (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:HAMMOND
Last Name:MCGOWEN
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 1:90 OAK TREE LN SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-5611
Mailing Address - Country:US
Mailing Address - Phone:330-609-7296
Mailing Address - Fax:330-856-2043
Practice Address - Street 1:90 OAK TREE LN SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-5611
Practice Address - Country:US
Practice Address - Phone:330-609-7296
Practice Address - Fax:330-856-2043
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.025084207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine