Provider Demographics
NPI:1356394688
Name:BOWERS, DON LOWELL (DO)
Entity type:Individual
Prefix:
First Name:DON
Middle Name:LOWELL
Last Name:BOWERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15515 CLARIDON TROY RD
Mailing Address - Street 2:P.O.BOX 804
Mailing Address - City:BURTON
Mailing Address - State:OH
Mailing Address - Zip Code:44021-9644
Mailing Address - Country:US
Mailing Address - Phone:440-834-1583
Mailing Address - Fax:
Practice Address - Street 1:3909 ORANGE PL
Practice Address - Street 2:STE 2100
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4478
Practice Address - Country:US
Practice Address - Phone:216-896-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-6372207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0322903Medicaid
OHBO4208601Medicare PIN
OHG50938Medicare UPIN