Individual
DEDRICK K. BOWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 BROADWAY STE 315, FORT WAYNE, IN 46802-2149
(260) 425-3782
(260) 425-3783
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3514
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
01079699A
IN
207RP1001X
Pulmonary Disease Physician
Primary
01079699A
IN
Other
Enumeration date
10/08/2012
Last updated
06/02/2022
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