Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 35052275 | OH |
N | 2081S0010X | Sports Medicine | 35052275 | OH |
N | 213ES0000X | Sports Medicine | 35052275 | OH |
NPI | 1285680058 |
---|---|
Provider Name | Brian L. Bowyer |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43210-1229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 23/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0659612 | (05) | OH |
A16811 | (02) |