| Doctor Name: | M. LUISA C BOWZARD |
| NPI Number: | 1093955395 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.A. |
| License Number: | 003620 |
| Business Practice Address: | 3820 Medical Park Dr Austell, GA - 301061110 |
| Business Phone Number: | 7709486041 |
| Business Fax Number: | 7709487994 |
| Mailing Address: | 3820 Medical Park Dr, AUSTELL |
| State: | GA |
| Postal Code: | 301061110 |
| Phone Number: | 7709485409 |
| Fax Number: | 7709487994 |
| NPI Enumeration Date: | 02/26/2009 |
| NPI Last Update Date: | 07/09/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 003620 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |