Basic Information
| Provider Information | |||||||||
| NPI: | 1548436884 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOWERS | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | RICHARD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 OSTRUM ST | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | FOUNTAIN HILL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180151155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4845262200 | ||||||||
| FaxNumber: | 4845262398 | ||||||||
| Practice Location | |||||||||
| Address1: | 701 OSTRUM ST | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | FOUNTAIN HILL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180151155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4845262200 | ||||||||
| FaxNumber: | 4845262398 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2008 | ||||||||
| LastUpdateDate: | 09/30/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | C7-0004010 | DE | N | Allopathic & Osteopathic Physicians | Surgery | 207Q00000X | OT012039 | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | OS015481 | NJ | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | OS015481 | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | 2083P0011X | OS015481 | PA | Y | Allopathic & Osteopathic Physicians | Preventive Medicine | Undersea and Hyperbaric Medicine |
ID Information
| ID | Type | State | Issuer | Description | 102932210 | 05 | PA | MEDICAID |