Provider Demographics
NPI:1972543841
Name:BOWEN, JOHN H (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:H
Last Name:BOWEN
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:1041 MORGANTON BLVD SW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5605
Mailing Address - Country:US
Mailing Address - Phone:828-991-4660
Mailing Address - Fax:
Practice Address - Street 1:1041 MORGANTON BLVD SW
Practice Address - Street 2:SUITE 200
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5605
Practice Address - Country:US
Practice Address - Phone:828-991-4660
Practice Address - Fax:828-991-4659
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC25852207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC17080OtherBCBS
NC1972543841Medicaid
NC7917080Medicaid
NC7917080Medicaid