Provider Demographics
NPI:1487628277
Name:BOWEN, PAUL ALLEN II (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ALLEN
Last Name:BOWEN
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:208 SCRANTON CONNECTOR
Mailing Address - Street 2:SUITE 117
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-0559
Mailing Address - Country:US
Mailing Address - Phone:912-264-5961
Mailing Address - Fax:912-262-9499
Practice Address - Street 1:208 SCRANTON CONNECTOR
Practice Address - Street 2:SUITE 117
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-0559
Practice Address - Country:US
Practice Address - Phone:912-264-5961
Practice Address - Fax:912-262-9499
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2010-03-04
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Provider Licenses
StateLicense IDTaxonomies
GA020965207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00401185OtherRAILROAD MEDICARE
GA000264173DMedicaid
GA52210475OtherBLUE CROSS/BLUE SHIELD
P00401185OtherRAILROAD MEDICARE
GA$$$$$$$$$OtherTRICARE
P00401185OtherRAILROAD MEDICARE