Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | D67402 | MD |
N | 207N00000X | Dermatologist | MD037215 | DC |
Y | 207N00000X | Dermatologist | MD439184 | PA |
N | 207ND0101X | MOHS-Micrographic Surgeon | D0067402 | MD |
N | 207ND0101X | MOHS-Micrographic Surgeon | MD037215 | DC |
N | 207ND0101X | MOHS-Micrographic Surgeon | MD439184 | PA |
NPI | 1487795993 |
---|---|
Provider Name | David A Cowan |
First Address | Butler, PA 16001-1784 |
Second Address | Butler, PA 16001-1784 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 22/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102448590 | (05) | PA |