Individual
DR. DIANE GWYN BOWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1015 ARTHUR J MOORE DR, SAINT SIMONS ISLAND, GA 31522-2206
(912) 634-1993
(912) 634-1166
Mailing address
1015 ARTHUR J MOORE DR, SAINT SIMONS ISLAND, GA 31522-2206
(912) 634-1993
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
31386
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11340888
CAQH NUMBER
GA
Enumeration date
07/26/2006
Last updated
07/08/2007
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