Provider Demographics
NPI:1992830707
Name:BOWEN, STEPHEN J SR (NP)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:J
Last Name:BOWEN
Suffix:SR
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 WEATHERGLASS LN
Mailing Address - Street 2:
Mailing Address - City:EAST FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02536-6036
Mailing Address - Country:US
Mailing Address - Phone:781-738-6023
Mailing Address - Fax:
Practice Address - Street 1:37 WEATHERGLASS LN
Practice Address - Street 2:
Practice Address - City:EAST FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02536-6036
Practice Address - Country:US
Practice Address - Phone:781-738-6023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA217099363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MABO NP4397Medicare ID - Type Unspecified