Provider Demographics
NPI:1104314368
Name:BOWSER, MEGHAN (MD)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:BOWSER
Suffix:
Gender:F
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:ACADEMIC HEALTH CENTER ROOM 408
Mailing Address - Street 2:1600 SW ARCHER ROAD
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607
Mailing Address - Country:US
Mailing Address - Phone:352-273-8234
Mailing Address - Fax:
Practice Address - Street 1:1658 ST VINCENTS WAY STE 320
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-8459
Practice Address - Country:US
Practice Address - Phone:904-602-4330
Practice Address - Fax:904-602-4371
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME150289208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program