Provider Demographics
NPI:1891055281
Name:BOWEN, WILLIAM MCCORMICK (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:MCCORMICK
Last Name:BOWEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5501 HERRERA DR SUITE B
Mailing Address - Street 2:CHRISTUS ST. VINCENT URGENT CARE ENTRADA CONTENTA
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-2677
Mailing Address - Country:US
Mailing Address - Phone:505-913-4180
Mailing Address - Fax:505-913-4181
Practice Address - Street 1:5501 HERRERA DR SUITE B
Practice Address - Street 2:CHRISTUS ST. VINCENT URGENT CARE ENTRADA CONTENTA
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-2677
Practice Address - Country:US
Practice Address - Phone:505-913-4180
Practice Address - Fax:505-913-4181
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2015-0021207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine