Provider Demographics
NPI:1588985766
Name:BOWMAN, LAURA CATHERINE (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:CATHERINE
Last Name:BOWMAN
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 1:66 DOUGLAS ST SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30317-2624
Mailing Address - Country:US
Mailing Address - Phone:404-697-1714
Mailing Address - Fax:
Practice Address - Street 1:6255 BARFIELD RD NE STE 175
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-4338
Practice Address - Country:US
Practice Address - Phone:404-255-8388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2022-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171100000X
GA50471207RA0401X, 2080P0207X, 2084P0800X, 251S00000X, 2083A0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction MedicineGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturist
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-OncologyGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty