Provider Demographics
NPI:1629068119
Name:BOWERS, GEORGE R (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:R
Last Name:BOWERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2052
Mailing Address - Country:US
Mailing Address - Phone:413-582-2900
Mailing Address - Fax:413-582-2905
Practice Address - Street 1:30 LOCUST ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2052
Practice Address - Country:US
Practice Address - Phone:413-582-2900
Practice Address - Fax:413-582-2905
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA56968207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME056968OtherTUFTS HEALTH PLAN
ME000000006707OtherBMC HEALTHNET
ME5931217OtherAETNA PROVIDER NUMBER
ME102541OtherCIGNA
ME569681OtherCONNECTICARE
ME14383OtherHARVARD PILGRIM HEALTHCAR
MA2055562Medicaid
MEG14105OtherBCBSMA
ME102541OtherCIGNA
ME569681OtherCONNECTICARE