Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 050475 | CT |
NPI | 1104851294 |
---|---|
Provider Name | Dr. Jonathan Norton Bowman |
First Address | Shelton, CT 06484-6228 |
Second Address | Darien, CT 06820-4732 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 16/12/2020 |