Provider Demographics
NPI:1669749222
Name:WHITE, BOWEN FAVILLE (MD)
Entity type:Individual
Prefix:DR
First Name:BOWEN
Middle Name:FAVILLE
Last Name:WHITE
Suffix:
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 1:9218 METCALF AVE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-1476
Mailing Address - Country:US
Mailing Address - Phone:816-721-0857
Mailing Address - Fax:
Practice Address - Street 1:8646 MAIDEN LN
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-3033
Practice Address - Country:US
Practice Address - Phone:816-721-0857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6A22207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine