Provider Demographics
NPI:1184601783
Name:MOWE, DEBORAH ANN (MD)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:MOWE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 ALHAMBRA BLVD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5238
Mailing Address - Country:US
Mailing Address - Phone:916-731-7965
Mailing Address - Fax:916-731-7936
Practice Address - Street 1:1201 ALHAMBRA BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5238
Practice Address - Country:US
Practice Address - Phone:916-731-7965
Practice Address - Fax:916-731-7936
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV18881207Q00000X
CAG61669207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV080112318OtherRAILROAD MEDICARE
WV0054802000Medicaid
WVD91473Medicare UPIN
WV0054802000Medicaid
WV2033745Medicare PIN
WV2033746Medicare PIN
WV2033747Medicare PIN
WV2033742Medicare PIN
WV2033743Medicare PIN
WV080112318OtherRAILROAD MEDICARE