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Individual

DR. STANLEY CLYDE BOWSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1725B DUAL HWY, HAGERSTOWN, MD 21740-6653
(301) 739-6573
(301) 739-6577
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(866) 795-4020

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
OET008772
PA
152W00000X
Optometrist
Primary
TA0981
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0018624220001
PA
01
410046919
RAILROAD MEDICARE
01
B01314766
HIGHMARK BLUE SHIELD
PA
Enumeration date
12/01/2006
Last updated
01/29/2018
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