Provider Demographics
NPI:1205260064
Name:BOWMAN, PAMELA DENISE (PHARMD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:DENISE
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9008 KENTSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-8720
Mailing Address - Country:US
Mailing Address - Phone:704-568-7087
Mailing Address - Fax:
Practice Address - Street 1:9008 KENTSHIRE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-8720
Practice Address - Country:US
Practice Address - Phone:704-568-7087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9003183500000X
NC17475183500000X
VA0202012764183500000X
MD16548183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist