Individual
CASEY JEWELL COWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 726-2000
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 726-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2384
SC
363AM0700X
Medical Physician Assistant
2384
SC
363AM0700X
Medical Physician Assistant
Primary
PA5057
MA
Other
Enumeration date
04/11/2014
Last updated
10/16/2019
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