Provider Demographics
NPI:1881913887
Name:BOWER, AMY MINGCHU (PA-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MINGCHU
Last Name:BOWER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MINGCHU
Other - Middle Name:
Other - Last Name:TSAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:23 SUMPTION RD
Mailing Address - Street 2:
Mailing Address - City:SANDIA PARK
Mailing Address - State:NM
Mailing Address - Zip Code:87047-9456
Mailing Address - Country:US
Mailing Address - Phone:919-271-1124
Mailing Address - Fax:
Practice Address - Street 1:23 SUMPTION RD
Practice Address - Street 2:
Practice Address - City:SANDIA PARK
Practice Address - State:NM
Practice Address - Zip Code:87047-9456
Practice Address - Country:US
Practice Address - Phone:919-271-1124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-31
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical