Basic Information
| Provider Information | |||||||||
| NPI: | 1679615884 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COWAN | ||||||||
| FirstName: | ANNE | ||||||||
| MiddleName: | REIS | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 330 TURNER MCCALL BLVD SW STE 107 | ||||||||
| Address2: | |||||||||
| City: | ROME | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301655631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7065096439 | ||||||||
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| Practice Location | |||||||||
| Address1: | 330 TURNER MCCALL BLVD SW STE 107 | ||||||||
| Address2: | |||||||||
| City: | ROME | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301655631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7347635828 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2007 | ||||||||
| LastUpdateDate: | 08/10/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 4301079719 | MI | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.