Provider Demographics
NPI:1699720193
Name:COWAN, DOUGLAS E (MD)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:E
Last Name:COWAN
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:110 SOUTH BEDFORD ROAD
Mailing Address - Street 2:BEDFORD ANESTHESIA, PLLC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3412
Mailing Address - Country:US
Mailing Address - Phone:914-244-6789
Mailing Address - Fax:914-244-6760
Practice Address - Street 1:34 SOUTH BEDFORD ROAD
Practice Address - Street 2:BEDFORD ANESTHESIA, PLLC
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549
Practice Address - Country:US
Practice Address - Phone:914-244-6789
Practice Address - Fax:914-244-6760
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY208092207L00000X, 207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDB5589OtherGROUP MEDICARE RAILROAD
NY0X3202Medicare PIN
NY0X320LM261Medicare PIN
NYE43742Medicare UPIN
NYDB5589OtherGROUP MEDICARE RAILROAD