Provider Demographics
NPI:1437474384
Name:BOWEN, JOHN BYERS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BYERS
Last Name:BOWEN
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 1:5818 HARBOUR VIEW BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3315
Mailing Address - Country:US
Mailing Address - Phone:757-347-1377
Mailing Address - Fax:757-394-1444
Practice Address - Street 1:5818 HARBOUR VIEW BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3315
Practice Address - Country:US
Practice Address - Phone:757-347-1377
Practice Address - Fax:757-394-1444
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012641572086S0122X
VA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program