Provider Demographics
NPI:1598880056
Name:DENNIS BOWSHER MD PA
Entity Type:Organization
Organization Name:DENNIS BOWSHER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWSHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-781-8300
Mailing Address - Street 1:440 E SAMPLE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-4432
Mailing Address - Country:US
Mailing Address - Phone:954-781-8300
Mailing Address - Fax:954-781-8938
Practice Address - Street 1:440 E SAMPLE RD STE 102
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-4432
Practice Address - Country:US
Practice Address - Phone:954-781-8300
Practice Address - Fax:954-781-8938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME59486207R00000X, 207RC0000X, 207UN0901X, 208U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208U00000XAllopathic & Osteopathic PhysiciansClinical PharmacologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP03000107437OtherDIVISION OF CORPORATIONS
FL=========OtherFEDERAL TAX ID NUMBER