Provider Demographics
NPI:1740402122
Name:BOWER, DOUGLAS (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:
Last Name:BOWER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:133 E FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2222
Mailing Address - Country:US
Mailing Address - Phone:717-394-9821
Mailing Address - Fax:717-394-0175
Practice Address - Street 1:133 E FREDERICK ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2222
Practice Address - Country:US
Practice Address - Phone:717-394-9821
Practice Address - Fax:717-394-0175
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD438495207L00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology