1992895361 NPI number — MELVA RICHARDSON BOWMAN M.D.

Table of content: MS. AMANDA GAIL UPRIGHT (NPI 1659971612)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992895361 NPI number — MELVA RICHARDSON BOWMAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOWMAN
Provider First Name:
MELVA
Provider Middle Name:
RICHARDSON
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

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:
1992895361
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/08/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1209
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMLET
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28345-1209
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-582-2696
Provider Business Mailing Address Fax Number:
910-582-2640

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
224 W MAIN ST STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMLET
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28345-3322
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-582-2696
Provider Business Practice Location Address Fax Number:
910-582-2640
Provider Enumeration Date:
10/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  35275 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 5911090 . This is a "AETNA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 562244049 . This is a "TRICARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 8917073 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: A6903 . This is a "MEDCOST" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 17073 . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 562244049 . This is a "CIGNA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: FH1000335 . This is a "FIRSTCAROLINACARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com