| Doctor Name: | DR. GEORGE LANGSTROTH COWAN |
| NPI Number: | 1740365691 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | |
| Business Practice Address: | 620 John Paul Jones Cir Psychiatry Department Portsmouth, VA - 237082111 |
| Business Phone Number: | 7579535269 |
| Business Fax Number: | 7579536907 |
| Mailing Address: | 680 Borkowitz Rd, SCRANTON |
| State: | SC |
| Postal Code: | 295915188 |
| Phone Number: | 8436105727 |
| Fax Number: | |
| NPI Enumeration Date: | 10/26/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171000000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Military Health Care Provider |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |