Provider Demographics
NPI:1366187478
Name:BOWMAN, ALEXANDRA GARRETT (DO)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:GARRETT
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4605 MACCORKLE AVE SW
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1311
Mailing Address - Country:US
Mailing Address - Phone:304-766-3600
Mailing Address - Fax:
Practice Address - Street 1:506 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1204
Practice Address - Country:US
Practice Address - Phone:304-766-8558
Practice Address - Fax:304-766-8561
Is Sole Proprietor?:No
Enumeration Date:2022-05-03
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV4128207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine