Provider Demographics
NPI:1467518589
Name:BOWERS, REGINA CRUZ (MD)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:CRUZ
Last Name:BOWERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REGINA
Other - Middle Name:ANNE
Other - Last Name:CRUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:224 S WOODS MILL RD
Mailing Address - Street 2:570-S
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3451
Mailing Address - Country:US
Mailing Address - Phone:314-878-2556
Mailing Address - Fax:314-742-2775
Practice Address - Street 1:224 S WOODS MILL RD
Practice Address - Street 2:570-S
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3451
Practice Address - Country:US
Practice Address - Phone:314-878-2556
Practice Address - Fax:314-275-7442
Is Sole Proprietor?:No
Enumeration Date:2007-01-01
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002017786207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology