1396760468 NPI number — CHRISTOPHER COWHER, MD PLLC

Table of content: ALESCIA AUSTIN (NPI 1801361332)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396760468 NPI number — CHRISTOPHER COWHER, MD PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHRISTOPHER COWHER, MD PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396760468
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/23/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2160
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEIRTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26062-1360
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-723-3007
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
651 COLLIERS WAY
Provider Second Line Business Practice Location Address:
SUITE 411
Provider Business Practice Location Address City Name:
WEIRTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26062-5053
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-723-3007
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
COWHER
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
304-723-3007

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  18856 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0210288000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2356865 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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