Provider Demographics
NPI:1215433040
Name:BOWER, DAVID MARK (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MARK
Last Name:BOWER
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 1:4755 NW 120TH DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3541
Mailing Address - Country:US
Mailing Address - Phone:754-812-7357
Mailing Address - Fax:
Practice Address - Street 1:3920 NW 49TH ST
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33309-3308
Practice Address - Country:US
Practice Address - Phone:954-730-2333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1346982085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology