Provider Demographics
NPI:1568439750
Name:BOWIE, JOHN WESLEY (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:WESLEY
Last Name:BOWIE
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 1:6701 N CHARLES ST
Mailing Address - Street 2:#4902
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204
Mailing Address - Country:US
Mailing Address - Phone:410-377-7000
Mailing Address - Fax:410-377-4181
Practice Address - Street 1:6701 N CHARLES ST
Practice Address - Street 2:#4902
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-377-7000
Practice Address - Fax:410-377-4181
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD20649207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCE1160001OtherCAREFIRST
110194235OtherRAILROAD MEDICARE
500030OtherNATIONAL CAPITAL
0400045OtherUNITED HEALTHCARE MID ATL
101011716OtherCIGNA HEALTHCARE
MD30446002OtherCAREFIRST
PA768460OtherCAREFIRST
4341971OtherAETNA
MD975581100Medicaid
522186229OtherCOVENTRY
VA119706OtherCAREFIRST
38381OtherUNITED HEALTHCARE
PA768460OtherCAREFIRST
903L318EMedicare ID - Type Unspecified