Provider Demographics
NPI:1891910790
Name:BOWMAN, KARL F JR (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:F
Last Name:BOWMAN
Suffix:JR
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 1:5818 D HARBOUR VIEW BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3327
Mailing Address - Country:US
Mailing Address - Phone:757-215-1400
Mailing Address - Fax:757-215-1403
Practice Address - Street 1:2076 HWY. 42 WEST
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-5302
Practice Address - Country:US
Practice Address - Phone:919-763-1050
Practice Address - Fax:919-313-1276
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2018-02328207X00000X, 207XX0005X
VA010125194207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1891910790Medicaid
VA1891910790Medicaid