Individual
LISA RENEE COWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4565 FAYETTEVILLE ROAD, SUITE A, RAEFORD, NC 28376-0000
(910) 878-5100
(910) 878-5140
Mailing address
PO BOX 843298, BOSTON, MA 02284-3298
(910) 878-5100
(910) 878-5100
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2010-01286
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5915388
—
NC
Enumeration date
06/14/2007
Last updated
03/11/2013
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