1235334939 NPI number — DAVID M. COWAN, PHD, PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235334939 NPI number — DAVID M. COWAN, PHD, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAVID M. COWAN, PHD, 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:
1235334939
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/27/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
43902 WOODWARD AVE
Provider Second Line Business Mailing Address:
SUITE 116
Provider Business Mailing Address City Name:
BLOOMFIELD HILLS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48302-5011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-745-0425
Provider Business Mailing Address Fax Number:
248-745-0536

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
43902 WOODWARD AVE
Provider Second Line Business Practice Location Address:
SUITE 116
Provider Business Practice Location Address City Name:
BLOOMFIELD HILLS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48302-5011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-745-0425
Provider Business Practice Location Address Fax Number:
248-745-0536
Provider Enumeration Date:
06/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
COWAN
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
248-745-0425

Provider Taxonomy Codes

  • Taxonomy code: 103G00000X , with the licence number:  6301005488 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X , with the licence number: 6301005488 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: 6301005488 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TF0200X , with the licence number: 6301005488 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TH0004X , with the licence number: 6301005488 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TR0400X , with the licence number: 6301005488 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 099023 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 2107494 . This is a "CIGNA" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 126823 . This is a "CARE CHOICES" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 2119722934101 . This is a "BEECH STREET" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 037721 . This is a "VALUE OPTIONS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: BM630101 . This is a "MCARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: P83423 . This is a "BLUE CARE NETWORK" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 099023 . This is a "MHN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1062699 . This is a "IHP" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 47988 . This is a "HEALTH ALLIANCE PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 9309 . This is a "CAPE HEALTH PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 00836270723200 . This is a "LIBERTY MUTUAL" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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