Provider Demographics
NPI:1508800988
Name:BOWEN, STEVEN K (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:K
Last Name:BOWEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:620 BRISBANE CT
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-2549
Mailing Address - Country:US
Mailing Address - Phone:910-486-4486
Mailing Address - Fax:910-486-0097
Practice Address - Street 1:1645 OWEN DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3425
Practice Address - Country:US
Practice Address - Phone:910-486-4486
Practice Address - Fax:910-486-0097
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC314213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890805MMedicaid
NC890805MMedicaid
NCU29006Medicare UPIN