Provider Demographics
NPI:1619036597
Name:BOWERS, MICHAEL G (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:G
Last Name:BOWERS
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Gender:M
Credentials:DO
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Mailing Address - Street 1:PO BOX 791128
Mailing Address - Street 2:LL20
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-1128
Mailing Address - Country:US
Mailing Address - Phone:703-391-2030
Mailing Address - Fax:703-273-3943
Practice Address - Street 1:12110 SUNSET HILLS ROAD
Practice Address - Street 2:LL20
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190
Practice Address - Country:US
Practice Address - Phone:703-834-1473
Practice Address - Fax:703-318-7463
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2023-11-27
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Provider Licenses
StateLicense IDTaxonomies
VA0102201349207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine