Provider Demographics
NPI:1386859783
Name:COWENS, KENNETH GERARD (MD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:GERARD
Last Name:COWENS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12116 STATE ROUTE 30
Mailing Address - Street 2:MED EXPRESS URGENT CARE
Mailing Address - City:NORTH HUNTINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15624
Mailing Address - Country:US
Mailing Address - Phone:724-863-4362
Mailing Address - Fax:724-863-6024
Practice Address - Street 1:12116 STATE ROUTE 30
Practice Address - Street 2:MED EXPRESS URGENT CARE
Practice Address - City:NORTH HUNTINGTON
Practice Address - State:PA
Practice Address - Zip Code:15624
Practice Address - Country:US
Practice Address - Phone:724-863-4362
Practice Address - Fax:724-863-6024
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2014-08-27
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Provider Licenses
StateLicense IDTaxonomies
OH35054169207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0739286Medicaid
OH0739286Medicaid
OHD98055Medicare UPIN