Provider Demographics
NPI:1730149311
Name:BOWERS, MELISSA M (DO)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:M
Last Name:BOWERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13443 SIENNA MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-7909
Mailing Address - Country:US
Mailing Address - Phone:631-689-6226
Mailing Address - Fax:
Practice Address - Street 1:350 PINE ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-1669
Practice Address - Country:US
Practice Address - Phone:605-721-8939
Practice Address - Fax:605-721-8998
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD9418208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics