Provider Demographics
NPI:1588648109
Name:BOWERS, RICHARD A (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:BOWERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:400 BROAD ST
Mailing Address - Street 2:SUITE 2020
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1500
Mailing Address - Country:US
Mailing Address - Phone:412-741-4610
Mailing Address - Fax:412-741-8967
Practice Address - Street 1:400 BROAD ST
Practice Address - Street 2:SUITE 2020
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1500
Practice Address - Country:US
Practice Address - Phone:412-741-4610
Practice Address - Fax:412-741-8967
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD040063E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1263024Medicaid
PA686371Medicare ID - Type Unspecified
PA1263024Medicaid