Individual
MARK DAVID COWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1414 W FAIR AVE, SUITE 334, MARQUETTE, MI 49855-2675
(906) 225-3870
(906) 225-4861
Mailing address
1414 W FAIR AVE, SUITE 334, MARQUETTE, MI 49855-2675
(906) 225-3870
(906) 225-4861
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4301052687
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060035383
RAILROAD MEDICARE
—
01
—
0605200652
BLUE CROSS BLUE SHIELD
MI
05
—
1901057
—
MI
05
—
30596900
—
WI
Enumeration date
06/17/2006
Last updated
08/22/2013
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