Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 080046081N3ANP-PP | OR |
NPI | 1023165925 |
---|---|
Provider Name | Donald L Bowser |
First Address | Medford, OR 97504-4334 |
Second Address | Medford, OR 97504-4334 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
113790 | (02) | OR |