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Individual

MARILYN A. GOWEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7426
(757) 668-7784
Mailing address
PO BOX 79137, BALTIMORE, MD 21279-0137
(757) 668-7200
(757) 668-9691

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101045398
VA
2080P0214X
Pediatric Pulmonology Physician
Primary
0101045398
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000975001
DE
05
0018725450001
PA
05
006722067
VA
05
109921300
MD
05
6700074000
WV
05
890540I
NC
Enumeration date
05/12/2006
Last updated
12/09/2009
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