Provider Demographics
NPI:1487840013
Name:EDWARD B. BOWER, MD, PA
Entity Type:Organization
Organization Name:EDWARD B. BOWER, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:BOWER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-289-2561
Mailing Address - Street 1:900 E SUNSET DR
Mailing Address - Street 2:A
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28112-5893
Mailing Address - Country:US
Mailing Address - Phone:704-289-2561
Mailing Address - Fax:704-289-5148
Practice Address - Street 1:900 E SUNSET DR
Practice Address - Street 2:A
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5893
Practice Address - Country:US
Practice Address - Phone:704-289-2561
Practice Address - Fax:704-289-5148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0463Medicare PIN