Provider Demographics
NPI:1750644803
Name:BOWRY, KATHRYN ANNE (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANNE
Last Name:BOWRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 BLAIR MILL RD STE 20
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1041
Mailing Address - Country:US
Mailing Address - Phone:215-672-7070
Mailing Address - Fax:215-387-0031
Practice Address - Street 1:2701 BLAIR MILL RD STE 20
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1041
Practice Address - Country:US
Practice Address - Phone:215-672-7070
Practice Address - Fax:215-387-0031
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT201477207Q00000X
PAMD453458207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine