Provider Demographics
NPI:1730184714
Name:BOWNE, DAVID B (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:BOWNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1010 E MCDOWELL RD STE LL1
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2606
Mailing Address - Country:US
Mailing Address - Phone:602-956-1250
Mailing Address - Fax:602-956-7466
Practice Address - Street 1:4400 N 32ND ST STE 220
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3965
Practice Address - Country:US
Practice Address - Phone:602-956-1250
Practice Address - Fax:602-956-7466
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO112829174400000X
AZ37858207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ316931Medicaid