Provider Demographics
NPI:1790734226
Name:BOWEN, SAMUEL R II (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:R
Last Name:BOWEN
Suffix:II
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 1:806 ST. VINCENT'S DRIVE POB A
Mailing Address - Street 2:SUITE 450
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205
Mailing Address - Country:US
Mailing Address - Phone:205-986-5200
Mailing Address - Fax:205-986-5250
Practice Address - Street 1:806 ST. VINCENT'S DRIVE
Practice Address - Street 2:SUITE 450
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205
Practice Address - Country:US
Practice Address - Phone:205-986-5200
Practice Address - Fax:205-986-5250
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22511207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51007584OtherBLUE CROSS & BLUE SHIELD
ALG87660OtherSENIORS FIRST
ALG87660OtherHEALTHSPRING INSURANCE
AL9285291OtherCIGNA INSURANCE
AL000007584Medicaid
AL374211700OtherUS DEPT OF LABOR
AL0610083OtherUNITED HEALTH CARE
AL051007584OtherBLUE ADVANTAGE
ALG87660OtherHEALTHSPRING INSURANCE
AL000007584Medicaid
AL51007584OtherBLUE CROSS & BLUE SHIELD
AL6151720001Medicare NSC