Doctor Name: | MR. GERADE EUGENE BOWDEN |
NPI Number: | 1043458185 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | OPTICIAN |
License Number: | |
Business Practice Address: | 1650 Huntingdon Pk Suite 150 Meadowbrook, PA - 19046 |
Business Phone Number: | 2159476160 |
Business Fax Number: | 2159477425 |
Mailing Address: | 1650 Huntingdon Pk, Suite 150 MEADOWBROOK |
State: | PA |
Postal Code: | 19046 |
Phone Number: | 2159476160 |
Fax Number: | 2159477425 |
NPI Enumeration Date: | 01/28/2009 |
NPI Last Update Date: | 01/28/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |