Individual
DR. TRACEY WALSTON BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
137 THIRD STREET, AYDEN, NC 28513
(252) 746-3116
(252) 746-2394
Mailing address
PO BOX 427, AYDEN, NC 28513
(252) 746-3116
(252) 746-2394
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9801178
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8912243
—
NC
Enumeration date
04/01/2006
Last updated
11/03/2009
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