Provider Demographics
NPI:1598734493
Name:COWAN, BRUCE M (MD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:M
Last Name:COWAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:179 NORTHAMPTON ST
Mailing Address - Street 2:#G
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-1057
Mailing Address - Country:US
Mailing Address - Phone:413-527-8355
Mailing Address - Fax:413-527-9139
Practice Address - Street 1:179 NORTHAMPTON ST
Practice Address - Street 2:#G
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-1057
Practice Address - Country:US
Practice Address - Phone:413-527-8355
Practice Address - Fax:413-527-9139
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2008-06-12
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Provider Licenses
StateLicense IDTaxonomies
MA37412207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA04-3194547OtherCONSOLIDATED
MA04-3194547OtherNORTHEAST HEALTH DIRECT
MA04-3194547OtherNORTHEAST HEALTHCARE ALLI
MA2073811Medicaid
MA000000007733OtherBMC
MA04-3194547OtherUNICARE/GIC
MA20117OtherHEALTH NEW ENGLAND
MA774259OtherTUFTS
MA04-3194547OtherUNITED HEALTHCARE
MA2358508OtherAETNA
MA04-3194547OtherPRIVATE HEALTHCARE SYSTEM
MA63778OtherHARVARD PILGRIM
MAH05042OtherBCBSMA
MA04-3194547OtherGREAT-WEST
MA04-3194547OtherNORTH AMERICAN PREFERRED
MA04-3194547OtherPLAN VISTA
MA374121OtherCONNECTICARE
MA04-3194547OtherGREAT-WEST
MA04-3194547OtherUNITED HEALTHCARE
MA2358508OtherAETNA