Provider Demographics
NPI:1538179098
Name:BOWEN, LAURA M (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:M
Last Name:BOWEN
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 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:984-215-4110
Mailing Address - Fax:
Practice Address - Street 1:210 S CAMERON ST
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-2505
Practice Address - Country:US
Practice Address - Phone:919-732-9311
Practice Address - Fax:919-732-9315
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-00425207Q00000X
TNMD40277207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5905626Medicaid
NC144P5OtherBCBS
NC2061108BMedicare PIN
NC5905626Medicaid