Provider Demographics
NPI:1992735013
Name:BOWEN, KAREN ELINA (DO)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ELINA
Last Name:BOWEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-993-8181
Mailing Address - Fax:336-996-9539
Practice Address - Street 1:291 BROAD ST
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-2932
Practice Address - Country:US
Practice Address - Phone:336-993-8181
Practice Address - Fax:336-996-9539
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200501101207Q00000X
NC2005-01101207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC142X3OtherBCBS NC
NC191152OtherMEDCOST
NC7970821OtherAETNA
NC5904077Medicaid
NC808039OtherPARTNERS MEDICARE
NC7970821OtherAETNA
NCI56941Medicare UPIN
NC808039OtherPARTNERS MEDICARE