Provider Demographics
NPI:1861679953
Name:BARRINGTON H. BOWSER, JR., M.D., PLC
Entity Type:Organization
Organization Name:BARRINGTON H. BOWSER, JR., M.D., PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:SHIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-282-9133
Mailing Address - Street 1:5500 MONUMENT AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1452
Mailing Address - Country:US
Mailing Address - Phone:804-440-8425
Mailing Address - Fax:804-440-8427
Practice Address - Street 1:5500 MONUMENT AVE
Practice Address - Street 2:SUITE E
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1452
Practice Address - Country:US
Practice Address - Phone:804-440-8425
Practice Address - Fax:804-440-8427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101042472207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA=========OtherFEDERAL TAX ID