Provider Demographics
NPI:1881754711
Name:BOWERS, DAVID W (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:BOWERS
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:PO BOX 13579
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19612-3579
Mailing Address - Country:US
Mailing Address - Phone:484-628-0799
Mailing Address - Fax:
Practice Address - Street 1:5471B POTTSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:LEESPORT
Practice Address - State:PA
Practice Address - Zip Code:19533-8633
Practice Address - Country:US
Practice Address - Phone:610-916-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022369E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009046260004Medicaid
PA181365OtherHIGHMARK BLUE SHIELD
PA50065833OtherCAPITAL BLUE CROSS
PA50035017OtherCAPITAL BLUE CROSS
PA50050016OtherCAPITAL BLUE CROSS
PA50066335OtherCAPITAL BLUE CROSS
PAP006120OtherGATEWAY HEALTH PLAN
PA50066320OtherCAPITAL BLUE CROSS
PA50041082OtherCAPITAL BLUE CROSS
PA50066334OtherCAPITAL BLUE CROSS
PA1085331OtherAETNA HMO
PA50066332OtherCAPITAL BLUE CROSS
PA5021073OtherAETNA NON-HMO
PA010033150OtherRAILROAD MEDICARE
PA50065828OtherCAPITAL BLUE CROSS
PA50066326OtherCAPITAL BLUE CROSS
PA1085331OtherAETNA HMO
PA50066320OtherCAPITAL BLUE CROSS
PA5021073OtherAETNA NON-HMO
PAC32954Medicare UPIN