Provider Demographics
NPI:1558341453
Name:BOWER, BRIAN E (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:E
Last Name:BOWER
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 1:104 MEADOW POINTE
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-9209
Mailing Address - Country:US
Mailing Address - Phone:304-525-5405
Mailing Address - Fax:304-525-3400
Practice Address - Street 1:104 MEADOW POINTE
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-9209
Practice Address - Country:US
Practice Address - Phone:304-525-5405
Practice Address - Fax:304-525-3400
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20870207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV00058444OtherRR MEDICARE
WV001709560OtherMT. STATE
OH2379091Medicaid
KY64062474Medicaid
WV000000290738OtherANTHEM
WV1812261000Medicaid
WV000000290738OtherANTHEM
WV001709560OtherMT. STATE
WV2024068Medicare PIN
WV2024062Medicare PIN
OH2379091Medicaid
WV2024069Medicare PIN
WV2024064Medicare PIN
WV2024061Medicare PIN
WV1812261000Medicaid