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Individual
AMANDA C BOWERS
Active
Individual
AMANDA C BOWERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
279201
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042.0014718
STATE LICENSE
VT
01
—
1015844
ABP
—
01
—
14523875
CAQH
—
01
—
1470576
AAP
—
01
—
279201
STATE LICENSE
MA
01
—
470641
STATE LICENSE
PA
01
—
MCSR005248A
MCSR
MA
01
—
MD23166
STATE LICENSE
ME
Enumeration date
03/24/2016
Last updated
10/14/2022
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