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Individual
DR. LARRY A COWLEY
Active
Individual
DR. LARRY A COWLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0101038901
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006580271
—
VA
01
—
01201038901
STATE LICENSE
VA
01
—
075730
ANTHEM PROVIDER NUMBER
VA
01
—
5757016
AETNA PROVIDER NUMBER
—
Enumeration date
08/15/2006
Last updated
01/05/2015
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