Individual
TERRA MCDONALD BOWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1155 HEMBREE RD, STE. 210, ROSWELL, GA 30076-1122
(770) 740-1753
(770) 740-8503
Mailing address
805 SANDY PLAINS ROAD, MEDICAL STAFF SERVICES, MARIETTA, GA 30066-6340
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
002719
GA
363A00000X
Physician Assistant
2719
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002719
LICENCE
GA
Enumeration date
06/29/2006
Last updated
11/05/2019
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