Provider Demographics
NPI:1710106893
Name:STEVEN K BOWEN
Entity Type:Organization
Organization Name:STEVEN K BOWEN
Other - Org Name:CAROLINA FOOTCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:910-486-4486
Mailing Address - Street 1:1645 OWEN DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3425
Mailing Address - Country:US
Mailing Address - Phone:910-486-4486
Mailing Address - Fax:910-486-0097
Practice Address - Street 1:1645 OWEN DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3425
Practice Address - Country:US
Practice Address - Phone:910-486-4486
Practice Address - Fax:910-486-0097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890805MMedicaid
NC0204MOtherBLUE CROSS BLUE SHIELD
NC890204MMedicaid
NC0805MOtherBLUE CROSS BLUE SHIELD
NC0204MOtherBLUE CROSS BLUE SHIELD
NCU29006Medicare UPIN