Provider Demographics
NPI:1629016639
Name:MOWERE, DAVID C (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:MOWERE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 SHADY OAKS CIR
Mailing Address - Street 2:SUITE 318
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3685
Mailing Address - Country:US
Mailing Address - Phone:407-497-4808
Mailing Address - Fax:
Practice Address - Street 1:661 E ALTAMONTE DR
Practice Address - Street 2:SUITE 318
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-5105
Practice Address - Country:US
Practice Address - Phone:407-303-5280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38226207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL065445100Medicaid
FL59290OtherBCBS
FL59290OtherBCBS
FL59290Medicare PIN